Transcript
Rad-8
®
Pulse Oximeter
Signal Extraction Pulse Oximeter OPERATOR’S MANUAL
Rad-8
®
Pulse Oximeter
Signal Extraction Pulse Oximeter OPERATOR’S MANUAL
The Rad-8 Operating Instructions provide the necessary information for proper operation of the Rad-8 instrument. General knowledge of pulse oximetry and an understanding of the features and functions of the Rad-8 are a prerequisite for its proper use. Do not operate the Rad-8 without completely reading and understanding the instructions in this manual. NOTICE: Purchase or possession of this instrument does not carry any express or implied license to use this instrument with replacement parts which would, alone or in combination with this instrument, fall within the scope of one of the patents relating to this instrument. CAUTION: Federal law (U.S.) restricts this instrument to sale by or on the order of a physician. Masimo Corporation 40 Parker Irvine, CA 92618 USA Tel.: 949-297-7000 Fax.: 949-297-7001 www.masimo.com EU Authorized Representative for Masimo Corporation:
EC REP MDSS GmbH Schiffgraben 41 30175 Hannover, Germany Tel.: +49-511-62 62 86 30 Fax.: +49-511-62 62 86 33
80fk
MEDICAL ELECTRICAL EQUIPMENT WITH RESPECT TO ELECTRIC SHOCK, FIRE AND MECHANICAL HAZARDS ONLY IN ACCORDANCE WITH UL 60601-1/CAN/CSA C22.2 No. 601.1
Covered by one or more of the following U.S. Patents: RE38,492, RE38,476, 7,221,971, 7,215,986, 7,215,984, 7,186,966, 6,979,812, 6,861,639, 6,850,787, 6,826,419, 6,816,741, 6,745,060, 6,699,194, 6,684,090, 6,654,624, 6,650,917, 6,643,530, 6,606,511, 6,515,273, 6,501,975, 6,463,311, 6,430,525, 6,360,114, 6,263,222, 6,236,872, 6,229,856, 6,157,850, 6,067,462, 6,011,986, 6,002,952, 5,919,134, 5,769,785, 5,758,644, 5,685,299, 5,632,272, 5,490,505, 5,482,036, international equivalents, or one or more of the patents referenced at www.masimo.com/ patents.htm. Other patents pending. © 2009 Masimo Corporation. Masimo, Discrete Saturation Transform, DST, DCI, Signal Extraction Technology, SET, Radical, , Rad-8, Signal IQ, SIQ, FastSat, LNOP and LNCS are federally registered trademarks of Masimo Corporation. M-LNCS, M-LNC, LNOPv and APOD are trademarks of Masimo Corporation.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
i
SAFETY INFORMATION, WARNINGS, CAUTIONS AND NOTES
The Rad-8 Pulse Oximeter is designed to minimize the possibility of hazards from errors in the software program by following sound engineering design processes, Risk Analysis and Software Validation. ■ Explosion hazard. Do not use the Rad-8 in the presence of flammable anesthetics or other flammable substance in combination with air, oxygen-enriched environments, or nitrous oxide. ■ High intensity extreme lights (including pulsating strobe lights) directed on the sensor, may not allow the Pulse Oximeter to obtain readings. ■ The Rad-8 is NOT intended for use as an apnea monitor. ■ The Pulse Oximeter should be considered an early warning instrument. As a trend towards patient hypoxemia is indicated, blood samples should be analyzed by laboratory instruments to completely understand the patient’s condition. ■ Pulse rate measurement is based on the optical detection of a peripheral flow pulse and therefore may not detect certain arrhythmias. The pulse oximeter should not be used as a replacement or substitute for ECG based arrhythmia analysis. ■ The Rad-8 is to be operated by qualified personnel only. This manual, accessory directions for use, all precautionary information, and specifications should be read before use. ■ Electric shock hazard. Do not open the Rad-8 instrument. Only a qualified operator may perform maintenance procedures specifically described in this manual. Refer servicing to Masimo for repair of this equipment. ■ As with all medical equipment, carefully route patient cabling to reduce the possibility of patient entanglement or strangulation. ■ Do not place the Rad-8 or accessories in any position that might cause it to fall on the patient. Do not lift the Rad-8 by the power cord or any other cable. ■ Interfering Substances: Dyes, or any substance containing dyes, that change usual blood pigmentation may cause erroneous readings. ■ SpO2 is empirically calibrated to functional arterial oxygen saturation in healthy adult volunteers with normal levels of carboxyhemoglobin (COHb) and methemoglobin (MetHb). A pulse oximeter can not measure elevated levels of COHb or MetHb. Increases in either COHb or MetHb will affect the accuracy of the SpO2 measurement. ■ For increased COHb: COHb levels above normal tend to increase the level of SpO2. The level of increase is approximately equal to the amount of COHb that is present. NOTE: High levels of COHb may occur with a seemingly normal SpO2. When elevated levels of COHb are suspected, laboratory analysis (co-oximetry) of a blood sample should be performed. ■ Elevated levels of Methemoglobin (MetHb) will lead to inaccurate SpO2 measurements. When elevated levels of MetHb are suspected, laboratory analysis (co-oximetry) of a blood sample should be performed. ■ Elevated levels of Carboxyhemoglobin (COHb) will lead to inaccurate SpO2 measurements. When elevated levels of COHb are suspected, laboratory analysis (co-oximetry) of a blood sample should be performed. ■ Elevated levels of Total Bilirubin may lead to inaccurate SpO2 measurements. ■ Severe anemia may cause erroneous SpO2 readings. ■ Do not use the Rad-8 or sensors during magnetic resonance imaging (MRI) scanning. Induced current could potentially cause burns. The Rad-8 may affect the MRI image and the MRI instrument may affect the accuracy of the Pulse Oximetry parameters and measurements.
ii
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
SAFETY INFORMATION, WARNINGS, CAUTIONS AND NOTES
■ If using Rad-8 during full body radiation, keep the sensor out of the radiation field. If the sensor is exposed to the radiation, the reading might be inaccurate or the instrument might read zero for the duration of the active irradiation period. ■ For home use, ensure that the Rad-8 alarm can be heard from other rooms in the house especially when noisy appliances such as vacuum cleaners, dishwashers, clothes dryers, televisions, or radios are operating. ■ Always remove the sensor from the patient and completely disconnect the patient from the Rad-8 before bathing the patient. ■ Additional information specific to Masimo sensors including information about parameter/measurement performance during motion and low perfusion, may be found in the sensor's Directions For Use (DFU). ■ Do not place the Rad-8 where the controls can be changed by the patient. ■ Do not place the Rad-8 face against a surface. This will cause the alarm to be muffled. ■ Do not place the Rad-8 on electrical equipment that may affect the Pulse Oximeter, preventing it from working properly. ■ Do not expose the Rad-8 to excessive moisture such as direct exposure to rain. Excessive moisture can cause the instrument to perform inaccurately or fail. ■ Do not place containers with liquids on or near the Rad-8. Liquids spilled on the instrument may cause it to perform inaccurately or fail. ■ If the Rad-8 fails any part of the setup procedures or leakage tests, remove the instrument from operation until qualified service personnel have corrected the situation. ■ If a sensor is damaged in any way, discontinue use immediately. ■ Disposal of product - Comply with local laws in the disposal of the instrument and/or its accessories. ■ The Rad-8 can be used during defibrillation, but the readings may be inaccurate for up to 20 seconds. ■ This equipment has been tested and found to comply with the limits for medical devices to the EN 60601-1-2: 2002, Medical Device Directive 93/42/EEC. These limits are designed to provide reasonable protection against harmful interference in a typical medical installation. This equipment generates, uses and can radiate radio frequency energy and, if not installed and used in accordance with the instructions, may cause harmful interference to other devices in the vicinity. However, there is no guarantee that interference will not occur in a particular installation. If this equipment does cause harmful interference to other devices, which can be determined by turning the equipment off and on, the user is encouraged to try to correct the interference by one or more of the following measures: ■ Reorient or relocate the receiving instrument. ■ Increase the separation between the equipment. ■
■ ■ ■
Consult the manufacturer for help. A functional tester cannot be utilized to assess the accuracy of the Pulse Oximeter or any sensors. Ensure the speaker is not covered or the instrument is not placed face-down on bedding or other sound absorbing surface. To protect against injury from electric shock, follow the directions below: ■ Avoid placing the instrument on surfaces with visible liquid spills. ■ Do not soak or immerse the instrument in liquids. ■ Always turn off and disconnect the power cord from the AC power supply before cleaning the instrument. ■ Use cleaning solutions sparingly.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
iii
table of contents
SECTION 1 - OVERVIEW About This Manual........................................................................................................................ 1-1 Warnings, Cautions and Notes..................................................................................................... 1-2 Product Description ...................................................................................................................... 1-3 Features............................................................................................................................ 1-3 Optional Features ............................................................................................................. 1-3 Indications for Use ............................................................................................................ 1-3 Pulse Oximetry ............................................................................................................................. 1-4 SpO2 General Description................................................................................................ 1-4 Principle of Operation ....................................................................................................... 1-4 Functional Saturation........................................................................................................ 1-5 Rad-8 vs. Drawn Whole Blood Measurements ................................................................. 1-5 Signal Extraction Technology (SET) for SpO2 Measurements ........................................ 1-6 FastSat.............................................................................................................................. 1-6 Masimo SET Parallel Engines .......................................................................................... 1-6 Masimo SET DST ® ......................................................................................................... 1-7 SECTION 2 - SYSTEM DESCRIPTION Introduction ................................................................................................................................... 2-1 Rad-8 Front Panel (Horizonatal Model)....................................................................................... 2-2 Rad-8 - Front Panel (Vertical Model) ............................................................................................ 2-2 Rad-8 Front Panel Controls/Indicators ......................................................................................... 2-3 Rad-8 Rear Panel ......................................................................................................................... 2-4 Symbols ........................................................................................................................................ 2-5 SECTION 3 - SETUP Introduction ................................................................................................................................... 3-1 Unpacking and Inspection ............................................................................................................ 3-1 Preparation for Monitoring ............................................................................................................ 3-1 Power Requirements ........................................................................................................ 3-1 Initial Battery Charging ..................................................................................................... 3-2 Initial Installation ............................................................................................................... 3-2 SECTION 4 - OPERATION Introduction ................................................................................................................................... 4-1 Basic operation ............................................................................................................................. 4-1 General Setup and Use .................................................................................................... 4-1 Default Settings ................................................................................................................ 4-2 Factory Default and User Configurable Settings .............................................................. 4-3 Successful Monitoring .................................................................................................................. 4-4 Masimo Pulse Oximetry Sensors ..................................................................................... 4-4 Numeric Display - SpO2 ................................................................................................... 4-4 Numeric Display - Pulse Rate .......................................................................................... 4-5 Numeric Display - PI ......................................................................................................... 4-5 Low Perfusion ................................................................................................................... 4-5 Actions to be Taken .......................................................................................................... 4-6 Signal IQ - (SIQ) ............................................................................................................... 4-6 Sensor Placement ............................................................................................................ 4-7 Sensitivity.......................................................................................................................... 4-7 Low Battery Audible Alarm ............................................................................................... 4-8 Normal Patient Monitoring ............................................................................................................ 4-9 Setup Menu ...................................................................................................................... 4-9 Menu Navigation ............................................................................................................... 4-9 iv
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
table of contents
SECTION 4 - OPERATION (CONTINUED) Setup Menu Level 1 ......................................................................................................... 4-9 Alarm Limits ...................................................................................................................... 4-9 LED Brightness............................................................................................................... 4-10 Setup Menu Level 2 ....................................................................................................... 4-10 Alarm Volume ................................................................................................................. 4-10 Alarm Silence ................................................................................................................. 4-11 Alarm Delay .................................................................................................................... 4-11 Clear Trend ..................................................................................................................... 4-12 Button Volume................................................................................................................. 4-12 Sensitivity........................................................................................................................ 4-13 FastSat............................................................................................................................ 4-13 Setup Menu Level 3 (Enter Button + Down Button Menu Settings) ............................. 4-14 Averaging Time ............................................................................................................... 4-14 Rapid Desat Limit ........................................................................................................... 4-15 Alarm On/Off................................................................................................................... 4-15 Default Settings .............................................................................................................. 4-16 SmartTone On/Off........................................................................................................... 4-16 Year ................................................................................................................................. 4-17 Month .............................................................................................................................. 4-17 Day ................................................................................................................................. 4-18 Hour ............................................................................................................................... 4-18 Minute ............................................................................................................................ 4-19 Software Version ............................................................................................................ 4-19 Serial Output ................................................................................................................. 4-20 Interface Alarms ............................................................................................................ 4-20 Nurse Call ....................................................................................................................... 4-21 Polarity ............................................................................................................................ 4-21 Setup Menu Level 4 (Enter Button + Up Button Menu Settings) .................................. 4-22 Set Mode ........................................................................................................................ 4-22 System Interfaces ....................................................................................................................... 4-22 Philips VueLink Setup ..................................................................................................... 4-22 Patient Safety Net/RadNet Setup ................................................................................... 4-22 Trend Setup and Use.................................................................................................................. 4-23 Introduction ..................................................................................................................... 4-23 Trend Utility Installation................................................................................................... 4-23 TrendCom Utility Operation............................................................................................. 4-23 Erasing Trend Memory.................................................................................................... 4-23 Trend Data Format.......................................................................................................... 4-24 Sample Trend Output ...................................................................................................... 4-24 Home Mode Operation................................................................................................... 4-25 Sleep Mode Operation ................................................................................................... 4-25 SECTION 5 - ALARMS AND MESSAGES Alarm Identification ....................................................................................................................... 5-1 Alarm Indication............................................................................................................................ 5-1 Alarm Limits.................................................................................................................................. 5-2 Alarm Silence ..................................................................................................................... 5-3 Alarm Bell ........................................................................................................................... 5-3 Alarm On/Off ...................................................................................................................... 5-3 Messages ..................................................................................................................................... 5-4 Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
v
table of contents
SECTION 6 - TROUBLESHOOTING Troubleshooting ............................................................................................................................ 6-1 SECTION 7 - SPECIFICATIONS Rad-8 Specifications .................................................................................................................... 7-1 Performance ..................................................................................................................... 7-1 Accuracy ........................................................................................................................... 7-1 Electrical ........................................................................................................................... 7-1 Environmental ................................................................................................................... 7-1 Physical Characteristics.................................................................................................... 7-2 Serial Interface Specifications ...................................................................................................... 7-3 Serial Interface Setup ...................................................................................................... 7-3 Serial Printer Setup .......................................................................................................... 7-4 Nurse Call..................................................................................................................................... 7-4 Nurse Call Specifications ................................................................................................. 7-5 SECTION 8 - SENSORS & PATIENT CABLES Introduction ................................................................................................................................... 8-1 Selecting a Masimo SET Sensor...................................................................................... 8-1 Sensor Application Instructions ........................................................................................ 8-1 Masimo SpO2 Sensors................................................................................................................. 8-2 Red Direct Connect Sensors ........................................................................................... 8-2 ® LNOP Reusable Sensors ............................................................................................... 8-3 LNOPv™ Adhesive Sensors ............................................................................................ 8-3 ® LNOP Specialty Sensors................................................................................................ 8-3 ® LNCS Reusable Sensors .............................................................................................. 8-4 ® LNCS Adhesive Sensors ............................................................................................... 8-4 ® M-LNCS™ DCI & DCIP Sensors ................................................................................... 8-4 Sensor Accuracy .............................................................................................................. 8-5 Cleaning And Reuse Of Masimo Reusable Sensors and Cables.................................... 8-5 Reattachment of Single Use Adhesive Sensors .............................................................. 8-5 SECTION 9 - SERVICE AND MAINTENANCE Introduction ................................................................................................................................... 9-1 Cleaning ....................................................................................................................................... 9-1 Battery Service ............................................................................................................................ 9-2 Performance Verification ............................................................................................................... 9-2 Service and Repair....................................................................................................................... 9-4 Repair Policy..................................................................................................................... 9-4 Return Procedure ............................................................................................................. 9-4 Sales & End-user License Agreement ......................................................................................... 9-5 Warranty ....................................................................................................................................... 9-5 Exclusions .................................................................................................................................... 9-5 End-user License ......................................................................................................................... 9-6 Restrictions ................................................................................................................................... 9-7 SECTION 10 - ACCESSORIES Accessories ................................................................................................................................ 10-1
vi
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
overview
1
About This Manual This manual explains how to set up and use the Rad-8 Pulse Oximeter. Important safety information relating to general use of the Rad-8 Pulse Oximeter appears before this introduction. Other important safety information is located throughout the manual where appropriate. Read the entire safety information section before you operate the monitor. In addition to the safety section, this manual includes the following sections: SECTION 1
OVERVIEW gives a general description of pulse oximetry.
SECTION 2
SYSTEM DESCRIPTION describes the Rad-8 Pulse Oximeter system and its functions and features.
SECTION 3
SETUP describes how to setup the Rad-8 Pulse Oximeter for use.
SECTION 4
OPERATION describes the operation of the Rad-8 Pulse Oximetry system.
SECTION 5
ALARMS AND MESSAGES describes the alarm system messages.
SECTION 6
TROUBLESHOOTING describes troubleshooting information.
SECTION 7
SPECIFICATIONS gives the detailed specifications of the Rad-8 Pulse Oximeter.
SECTION 8
SENSORS AND PATIENT CABLES outlines how to use and care for the Masimo SET LNOP and LNCS sensors and Masimo SET patient cables.
SECTION 9
SERVICE AND MAINTENANCE describes how to maintain, service and obtain repair for the Rad-8 Pulse Oximeter.
SECTION 10
ACCESSORIES list the available Rad-8 accessories.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
1-1
1
overview Warnings, cautions and notes Please read and follow any warnings, cautions and notes presented throughout this manual. An explanation of these labels are as follows: A WARNING is provided when actions may result in a serious outcome (i.e., injury, serious adverse affect, death) to the patient or user. Look for text in a gray shaded box. Sample of Warning: WARNING: THIS IS A SAMPLE OF A WARNING STATEMENT.
A CAUTION is given when any special care is to be exercised by the patient or user to avoid injury to the patient, damage to this instrument or damage to other property. Sample of Caution: CAUTION: THIS IS A SAMPLE OF A CAUTION STATEMENT. A NOTE is provided when extra general information is applicable. Sample of Note: NOTE: This is a sample of a Note.
1-2
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
overview
1
Product Description The Rad-8 is a noninvasive, arterial oxygen saturation and pulse rate monitor. The Rad-8 features a multicolored LED display that continuously displays numeric values for SpO2 and pulse rate, as well as LED indicator bars for Perfusion Index (PI) and Signal Identification and Quality Indicator (Signal IQ ® ). The instrument consists of two models: the vertical Rad-8 and the horizontal Rad-8. FEATURES AND BENEFITS These features are common to the Rad-8: ■ Masimo SET is clinically proven to be the highest sensitivity and specificity pulse oximeter technology in the world. ■ Applicable for use on neonate, infant, pediatric and adult patients ■ Proven for accurate monitoring in motion and low perfusion environments ■ SpO2, pulse rate, alarm, and perfusion index displays ■ Signal I.Q. for signal identification and quality indication ■ FastSat® tracks rapid changes in arterial O2 saturation with high fidelity. ■ Variable pitch provides tonal variance for every 1% change in saturation. ■ Lightweight, convenient compact design ■ Audible and visual alarm for no sensor, sensor-off and low battery ■ One touch button access to alarms for High/Low saturation and High/Low pulse rate ■ User definable alarm limit settings ■ Sleep mode ■ Home mode ■ Stores up to 72 hours of trending memory ■ Adjustable alarm volume ■ Up to 7 hours Internal battery life with fully charged battery ■ Serial output port INDICATIONS FOR USE The Rad-8 Pulse Oximeter and accessories are indicated for the continuous, non-invasive monitoring of functional oxygen saturation of arterial hemoglobin (SpO2). The Rad-8 Pulse Oximeter and accessories are indicated for use with adult, pediatric, infant and neonatal patients during both motion and no motion conditions, who are well or poorly perfused patients in hospitals, hospital-type facilities, mobile and home environments.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
1-3
1
overview Pulse Oximetry SpO2 GENERAL DESCRIPTION Pulse Oximetry is a continuous and noninvasive method of measuring the level of arterial oxygen saturation in blood. The measurement is taken by placing a sensor on a patient, usually on the fingertip for adults and the hand or foot for neonates. The sensor is connected to the Pulse Oximetry instrument with a patient cable. The sensor collects signal data from the patient and sends it to the instrument. The following figure shows the general monitoring setup.
1. Instrument 2 Patient Cable
1 2
3. Sensor ®
3
PRINCIPLE OF OPERATION Pulse Oximetry is governed by the following principles: 1. Oxyhemoglobin (oxygenated blood) and deoxyhemoglobin (non-oxygenated blood) constituents differ in their absorption of visible and infrared light (using spectrophotometry, see figure below).
Absorption Spectra 8
Oxyhemoglobin
Absorption (mm-1)
Deoxyhemoglobin
6
4
2
0 600
650
700
750
800
850
900
950
1000
Wavelength (nm)
2. The amount of arterial blood in tissue changes with your pulse (photoplethysmography). Therefore, the amount of light absorbed by the varying quantities of arterial blood changes as well.
1-4
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
1
overview
PRINCIPLE OF OPERATION (CONTINUED) The Rad-8 Pulse Oximeter uses a two-wavelength pulsatile system to distinguish between oxygenated and deoxygenated blood. Signal data is obtained by passing red (rd) (660 nm wavelength) and infrared (ir) (905 nm wavelength) light through a capillary bed (for example a fingertip, a hand or a foot) and measuring changes in light absorption during the pulsatile cycle. This information may be useful to clinicians. The radiant power of the light is rated at 0.79mW (max.). See figure below. The Rad-8 utilizes a sensor with red and infrared light-emitting diodes (LEDs) that pass light through the site to a photodiode (detector). The detector receives the light, converts it into an electronic signal and sends it to the Rad-8 for calculation.
1
1. Light Emitting Diodes (LEDs) 2. Detector
2
Once the instrument receives the signal from the sensor, it utilizes Masimo SET signal extraction technology for calculation of the patient’s functional oxygen saturation and pulse rate. The maximum of the skin surface temperature is measured at an ambient temperature of less than 106º F (41º C). This is verified by Masimo sensor skin temperature test procedures. FUNCTIONAL SATURATION The Rad-8 is calibrated to measure and display functional saturation (SpO2): the amount of oxyhemoglobin expressed as a percentage of the hemoglobin that is available to transport oxygen. RAD-8 VS. DRAWN WHOLE BLOOD MEASUREMENTS When SpO2 measurements obtained from the Rad-8 (noninvasive) are compared to drawn whole blood (invasive) measurements by blood gas and/or laboratory oximetry methods, caution should be taken when evaluating and interpreting the results. The blood gas and/or laboratoryoximetry measurements may differ from the SpO2 measurements of the Rad-8 Pulse Oximeter. In the case of SpO2, different results are usually obtained from the arterial blood gas sample if the calculated measurement is not appropriately corrected for the effects of variables that shift the relationship between the partial pressure of oxygen (PO2) and saturation, such as: pH, temperature, the partial pressure of carbon dioxide (PCO2), 2,3-DPG, and fetal hemoglobin. As blood samples are usually taken over a period of 20 seconds (the time it takes to draw the blood) a meaningful comparison can only be achieved if the oxygen saturation of the patient is stable and not changing over the period of time that the blood gas sample is taken. Subsequently, blood gas and laboratory oximetry measurements of SpO2 may vary with the rapid administration of fluids and in procedures such as dialysis. Additionally, drawn, whole-blood testing can be affected by sample handling methods and time elapsed between blood draw and sample testing.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
1-5
1
overview
SIGNAL EXTRACTION TECHNOLOGY (SET) FOR SpO2 MEASUREMENTS Masimo Signal Extraction Technology’s signal processing differs from conventional pulse oximeters. Conventional pulse oximeters assume that arterial blood is the only blood moving (pulsating) in the measurement site. During patient motion, however, the venous blood also moves, causing conventional pulse oximeters to read low values, because they cannot distinguish between the arterial and venous blood movement (sometimes referred to as noise). Masimo SET pulse oximetry utilizes parallel engines and adaptive digital filtering. Adaptive filters are powerful because they are able to adapt to the varying physiologic signals and/or noise and separate them by looking at the whole signal and breaking it down to its fundamental components. The Masimo SET signal processing algorithm, Discrete Saturation Transform® (DST®) reliably identifies the noise, isolates it and, using adaptive filters, cancels it. It then reports the true arterial oxygen saturation for display on the monitor. FASTSAT FastSat enables rapid tracking of arterial oxygen saturation changes. Arterial oxygen saturation data is averaged using pulse oximeter averaging algorithms to smooth the trend. When the Rad-8 is set to FastSat “On”, the averaging algorithm evaluates all the saturation values providing an averaged saturation value that is a better representation of the patient’s current oxygenation status. With FastSat, the averaging time is dependent on the input signal. MASIMO SET PARALLEL ENGINES
LED Wavelengths
R/IR (Conventional Pulse Oximetry)
Intermediate Calculations
DST ® Adaptive Filter
Intermediate Calculations
Confidence
Confidence
Intermediate Calculations
Pre-Processing & Data Reduction Digitized, Filtered & Normalized
1-6
SST ™
Confidence
FST: Proprietary Algorithm 3
Intermediate Calculations
FST: Proprietary Algorithm 4
Intermediate Calculations
Pulse Rate Algorithm
Intermediate Calculations
Confidence Based Arbitrator
Post Processor
Confidence
Confidence
%SpO2 PI
Confidence
PR
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
overview
1
MASIMO SET DST
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
1-7
system description
2
Introduction The Rad-8 is designed for ease of operation. All pulse oximetry measurement information, as well as instrument status data, is displayed on the front panel of the instrument. All user input is handled by control buttons on the front panel and the sensor cable connection is located on the left side (when horizontal) and on bottom of instrument (when vertical). Primary features include: ■ Full Masimo SET technology in a small compact instrument ■ Supports the full line of Masimo sensors and patient cables (see Section 8, Sensors and Patient Cables) ■ Supports standardization of sensors and pulse oximetry technology throughout the hospital
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
2-1
2
system description
RAD-8 FRONT PANEL (HORIZONTAL MODEL) 1
3
2
5
4
7
6
888 888
®
15
14
13
12
10
11
9
8
RAD-8 FRONT PANEL (VERTICAL MODEL)
7 6
8
5
4
888 888
9 10
11
3
12
2 13 1 14
15 ®
2-2
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
system description
2
Front Panel Controls/Indicators DESCRIPTION
CONTROL / INDICATOR 1
AC Power Indicator
The AC Power Indicator is illuminated when the instrument is connected to AC power.
2
Power On/Off
Press to turn the instrument on and off.
Up Button Down Button
Use these buttons to adjust the volume of the pulse beep tone. Within the menu/setup system, these buttons are used to select values within each menu option or the numeric value for the parameter/measurement alarm feature. Pressing and holding down these buttons allow for the rapid scrolling of alarm limits.
3
Used to enter the alarm limits menu in order to adjust Hi/Low SpO2, PI, and pulse rate alarm limits.
4
Alarm Limits Button
5
Signal IQ/Pulse Bar
6
Saturation Display
7
Alarm Silence Button
8
Alarm Bell
The alarm bell flashes to indicate an alarm condition.
9
Perfusion Index
The Perfusion Index provides an indication of the percentage of pulsatile signal to non pulsatile signal. The bar is highest when the quality of the perfused site is best.
10
Pulse Rate Display
The pulse rate in beats per minute (bpm). When searching for a saturation and pulse, “----” scrolls across the screen as the system calibrates and obtains patient data (approximately 10 seconds).
11
Enter Button
Used to enter the setup menus and to select/activate certain entries within the menu/setup system.
12
Brightness Button
Controls the level of the brightness for the LED display by providing 4 levels of brightness. Each press of the button increases the brightness one level. Once level 4 is accessed, an additional press of the button returns the brightness to level 1.
The LED indicator (located above the Alarm Limits Button) will illuminate when one or more of the factory default alarm settings is changed to alert the user to verify alarm settings. The Signal IQ provides an indication of the quality of the acquired signal as well as the timing of the pulse. A green vertical LED bar rises and falls with the pulse, where the height of the bar indicates the quality of the signal.
99
72
The functional arterial hemoglobin oxygen saturation is displayed in units of % for SpO2. When searching for a saturation and pulse, “----” scrolls across the screen as the system calibrates and obtains patient data (approximately 10 seconds). Press the Alarm Silence Button to temporarily silence patient and low battery alarms. Press the Alarm Silence Button when the “SEN OFF” message is flashing (i.e. the sensor is removed from the patient) to acknowledge the end of monitoring. In this state, all further alarms are silenced until the Pulse Oximeter starts measuring patient parameters/measurements again. NOTE: The alarm silence time can be set for 120, 30, 60 and 90 seconds. See Section 4, Setup Menu Level 2.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
2-3
system description
2
Front Panel Controls/Indicators continued DESCRIPTION
CONTROL / INDICATOR
Provides a visual representation of battery charge status. When unplugged, bars illuminate to indicate battery charge.
13
Battery Charge Level Indicator
14
Speaker
Provides audible indication of alarm conditions, pulse tone and feedback for key-presses.
15
Patient Cable Connector
Connects to a Masimo Pulse Oximeter sensor or Masimo Pulse Oximeter Patient Cable with a sensor.
A low battery status is indicated by a low audible beep and the first battery bar to the left flashing green.
RAD-8 REAR PANEL 1
4
2
3
2-4
1
NURSE CALL CONNECTOR
Use the 1/4” round Connector to interface with a nurse call system. This is a mono/stereo output and may be utilized with a mono or stereo cable. All external device connections to the Nurse Call Connector must be IEC-60950 compliant.
2
SERIAL OUTPUT CONNECTOR
Use the Serial Output Connector to connect a serial device, including a serial printer, to the Rad-8. See Section 7, Serial Interface Specifications. All external device connections to the Serial Output Connector must be IEC-60950 compliant.
3
POWER ENTRY MODULE
The power entry module contains the input connector for AC power. The AC input provides power to the system from the AC line. Always connect the pulse oximeter to the main power for continuous operation and/or battery recharging.
4
EQUIPOTENTIAL GROUND CONNECTOR
Use the Equipotential Ground Connector for grounding.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
2
system description
SYMBOLS The following symbols are found on the pulse oximeter or packaging and are defined below: SYMBOLS
DEFINITION RS-232 Equipotential Ground Terminal Caution, consult accompanying documents Nurse Call Interface WEEE compliant Defibrillation Proof (see front panel) Mark of Conformity to European Medical Device Directive 93/42/EEC
Rx Only
Federal law restricts this instrument to sale by or on the order of a physician (USA audiences only) Year of manufacture Underwriter's Laboratories Inc. certification Storage humidity range: 5% to 95%
5%-95% RH
+70 C
-40 C +1060 hPa - +500 hPa 795 mmHg - 375 mmHg
Storage temperature range: +70˚C to -40˚C Storage altitude range: +1600hPa to +500hPa Keep dry Fragile/breakable, handle with care Manufacturer
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
2-5
setup
3
Introduction Before the pulse oximeter can be used in a clinical setting, it needs to be inspected and properly setup with the battery fully charged. Unpacking and Inspection Remove the instrument from the shipping carton and examine it for signs of shipping damage. Check all materials against the packing list. Save all packing materials, invoice and bill of lading. These may be required to process a claim with the carrier. If anything is missing or damaged, contact the Technical Service Department. The contact address and phone numbers are listed in Section 9, Service and Repair. Preparation for Monitoring The following sections of the manual describe the preparation, set-up and initial installation of the Rad-8 Pulse Oximeter. POWER REQUIREMENTS Always use a hospital grade, AC power cable to connect the pulse oximeter to an AC power source. CAUTION: DO NOT CONNECT THE RAD-8 PULSE OXIMETER TO AN AC OUTLET CONTROLLED BY A SWITCH. Verify the AC power voltage and frequency before use. Verify that the power source can provide adequate power rating as indicated on the rear panel. The pulse oximeter is designed to operate on 100 to 240VAC, 47-63 Hz. The instrument is rated at 20 VA max. Connect a hospital grade power cable to the power entry module of the instrument (IEC-320 connector type at the instrument). Connect the power cable to an AC power source. Ensure that the instrument is adequately powered by verifying that the AC power indicator on the instrument is illuminated. CAUTION: ■ CONNECT THE RAD-8 ONLY TO A HOSPITAL-GRADE RECEPTACLE (FOR HOSPITAL USE). ■ DO NOT UNDER ANY CIRCUMSTANCES REMOVE THE GROUNDING CONDUCTOR FROM THE POWER PLUG. ■ DO NOT USE EXTENSION CORDS OR ADAPTERS OF ANY TYPE. THE POWER CORD AND PLUG MUST BE INTACT AND UNDAMAGED. ■ USE THE POWER CORD AS THE MEANS TO DISCONNECT THE INSTRUMENT FROM THE MAINS POWER SUPPLY. ■ IF THERE IS ANY DOUBT ABOUT THE INTEGRITY OF THE PROTECTIVE EARTH CONDUCTOR ARRANGEMENT, OPERATE THE OXIMETER ON INTERNAL BATTERY POWER UNTIL THE AC POWER SUPPLY PROTECTIVE CONDUCTOR IS FULLY FUNCTIONAL. ■ TO ENSURE PATIENT ELECTRICAL ISOLATION, CONNECT ONLY TO OTHER EQUIPMENT WITH ELECTRICALLY ISOLATED CIRCUITS. ■ DO NOT CONNECT TO AN ELECTRICAL OUTLET CONTROLLED BY A WALL SWITCH OR DIMMER. Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
3-1
3
setup
INITIAL BATTERY CHARGING Before use, the battery needs to be fully charged. To charge the internal battery, plug in the AC power cord. Verify that the battery is charging. The green AC power indicator on the instrument will illuminate while the battery is charging. CAUTION: TO AVOID EXCESSIVE BATTERY DISCHARGING, DO NOT CONNECT ANY EQUIPMENT TO THE SERIAL PORT ON THE BACK PANEL UNLESS THE PULSE OXIMETER IS CONNECTED TO THE AC MAIN POWER SUPPLY. INITIAL INSTALLATION Place the Rad-8 on a stable hard flat surface near the patient. Always place the Rad-8 on a dry surface. Maintain a minimum of 1 inch (2.54 cm) free space around the instrument. Make sure that Rad-8 loudspeaker is not covered to avoid a muffled alarm sound. The instrument should not be stored outside the following environmental conditions: ENVIRONMENTAL CONDITIONS TEMPERATURE
+5°C to +40°C, +41°F to +104°F
HUMIDITY
5% to 95%, non-condensing
OPERATING ALTITUDE
500 mbar to 1060 mbar pressure -1000 ft to 18,000 ft (-304 m to 5,486 m)
CAUTION: THE INSTRUMENT MUST BE CONFIGURED TO MATCH YOUR LOCAL POWER LINE FREQUENCY TO ALLOW FOR THE CANCELLATION OF NOISE INTRODUCED BY FLUORESCENT LIGHTS AND OTHER SOURCES. CAUTION: THE BATTERY SHOULD BE ADEQUATELY CHARGED TO ENSURE BACKUP POWER IN CASE OF AC POWER DISRUPTION.
3-2
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
operation
4
Introduction To operate the Rad-8 system effectively, the instrument must be set up correctly and the operator must ■ Know how the oximeter derives its readings (see Section 1, Pulse Oximetry) ■ Be familiar with its control components and operation (see Section 2, System Description). ■ Understand its status and alarm messages (see Section 5, Alarm Identification, System Messages and Section 6, Troubleshooting). Basic operation GENERAL SETUP AND USE 1. Inspect the Rad-8 case for damage. 2. Connect a patient cable or a direct connect sensor to the Rad-8 instrument. Make sure it is a firm connection and the cable is not twisted, sliced or frayed. 3. If utilizing a patient cable, select a sensor that is compatible with the Rad-8 and the patient before connecting it to the patient cable. See section 8, Sensors and Patient Cables. If using a single patient adhesive or disposable sensor, check that the emitter (red light) and the detector are properly aligned. Remove any substances that may interfere with the transmission of light between the sensor’s light source and detector. 4. Refer to the Directions for Use of the sensor before attaching the sensor to the patient. 5. Attach the Masimo sensor to the Patient. Connect the sensor to the patient cable with the logos lining up; make sure it is a firm connection. 6. Press the Power button to turn the Rad-8 on. 7. Verify all front-panel indicators momentarily illuminate and a tone is heard. 8. Verify the front-panel display is free of alarm and system failure messages (see Section 5, Alarms and Messages). 9. Verify the LED shows the following: ■ Mode setting: Standard (Std) or Sleep (SLP) or Home (Hnn). ■
SpO2 Low Alarm Limit and SpO2 High Alarm Limit,
■
Pulse Rate Low Alarm Limit and Pulse Rate High Alarm Limit.
10. On the display, verify the readings for SpO2 and pulse rate. NOTE: “- - -” will flash on the numeric display until the SpO2 and pulse rate readings have stabilized (approximately 10 seconds). 11. On the LED, verify the alarm limit settings. (See Setup Menu Level 1 in this section) 12. Verify that the patient alarms are functional by setting the high and low alarm limits beyond the patient readings. ■ An alarm tone sounds. ■ The Alarm Bell flashes red for high priority alarms. ■
The number value for the violated alarm limit will flash on the LED display.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
4-1
4
operation
GENERAL SETUP AND USE (CONTINUED) 13. Verify the sensor alarms are functional. ■ Remove the sensor from the sensor site. ■ The alarm tone sounds. ■ The Alarm Bell flashes red. ■ The display shows "SEN OFF" message. Disconnect the sensor from the patient cable or Rad-8. ■ The alarm tone sounds. ■ The Alarm Bell flashes red. ■ The display shows "NO SEN" message. NOTE: "NO SEN" or "SEN OFF" conditions will only generate a high priority alarm if the Rad-8 is actively monitoring a patient when the sensor is disconnected. 14. Verify that the audible alarm can be silenced when a parameter/measurement alarm is exceeded.
■ ■ ■
Create an alarm condition by lowering the SpO2 or pulse rate high alarm limits beyond the patient readings. Press the Alarm Silence button. The alarm tone ceases for 120 seconds (default). The Alarm Bell flashes red for a high pulse rate (high priority alarm).
15. To begin patient monitoring: ■ Adjust the alarm limits. ■ Adjust the alarm volume. ■ Adjust the pulse beep volume 16. Verify the sensor is applied correctly and that the measured data is appropriate, see Section 4, Successful Monitoring. 17. Monitor the patient. 18. After monitoring is complete, remove the sensor from the patient and store or dispose of the sensor according to local laws. See the Directions for Use of the sensor. 19. Press and hold the Power Button for 2 seconds to turn the Rad-8 off (3 seconds in the Home Mode). DEFAULT SETTINGS The Rad-8 Pulse Oximeter stores two types of default values that the instrument automatically retains after a power cycle. Default Settings are described in detail in Setup Menu Level 3. 1. Factory defaults set by Masimo. 2. User Configurable Default settings that can be changed by the user which will be remembered after a power cycle.
4-2
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
4
operation
FACTORY DEFAULT AND USER CONFIGURABLE SETTINGS
OPTION SpO2 high alarm limit* SpO2 low alarm limit* Pulse rate high alarm limit* Pulse rate low alarm limit* LED Brightness Alarm Volume Alarm Silence Alarm Delay Clear Trend Button Volume Sensitivity
FACTORY DEFAULT SETTINGS
USER CONFIGURABLE DEFAULT SETTINGS
"---" Off
2 to 99%
90%
1 to 99%
140 BPM
35 to 235 BPM
50 BPM
30 to 230 BPM
Level 3 Level 3 (70 dB min) 120 seconds 5 seconds Clear Trend (No) Level 2
Levels 1 thru 4 Levels 1 thru 4 30, 60, 90, or 120 seconds 0, 5, 10, or 15 seconds Clear Trend (Yes/No) Levels 1 thru 4 Max/Normal/APOD NOTE: MAX sensitivity will default to APOD after a power cycle. FastSat (On/Off)
APOD
FastSat
FastSat Off
Averaging Time
8 seconds (2 sec. in Sleep mode)
Section 4 Setup Menu Level 1
Section 4 Setup Menu Level 2
2, 4, 8, 10, 12, 14 and 16
Rapid Desat Alarm 5%
0, 5 and 10
Alarm On/Off
Alarms active (On)
On/Off or muted with reminder
Default Settings
No Change
User Default/Factory Default
SmartTone On/Off Year Month Day Hour Minute Serial Out Software Version Interface Alarms Nurse Call Polarity
Off (Normal Tone)
ASCII 2 System Software Alarms On Alarms Normal
On (SmartTone) Current year Current Month Current Day Current Hour Current Minute Philips/ASCII 1/ASCII 2 SET Software Alarms (On/Off) Alarms/SIQ/Alarms and SIQ Normal/Invert
Set Mode
Standard (Normal)
Standard/Sleep/Home**
Internal Clock
USER CONFIGURABLE DEFAULT SETTINGS REFERENCE
Section 4 Setup Menu Level 3
Section 4 Setup Menu Level 4
* User configurable settings will change back to factory defaults when power is turned off and on, unless user settings are locked in as User Defaults. Refer to Setup Menu Level 3 in this section to save user defaults. ** Home default setting will not change when power is turned off and on. Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
4-3
4
operation Successful Monitoring The following general points will aid in ensuring monitoring success. NOTE: See Safety Information, Warnings, Cautions and Notes for additional information. ■ Place the sensor on a site that has sufficient perfusion and provides proper alignment of the LED’s and detector. ■ Place the sensor on a site that has unrestricted blood flow. ■ Do not secure a sensor with tape. ■ Do not select a site near potential electrical interference (electro-surgical device, for example). ■ Read the sensor Directions for Use for proper sensor application. MASIMO PULSE OXIMETRY SENSORS Before use, carefully read the Masimo sensor Directions for Use. Use only Masimo sensors for pulse oximetry measurements. Tissue damage can be caused by incorrect application or use of a sensor, for example by wrapping the sensor too tightly. Inspect the sensor site as directed in the sensor Directions for Use to ensure skin integrity and correct positioning and adhesion of the sensor. CAUTIONS ■ DO NOT USE DAMAGED SENSORS. DO NOT USE A SENSOR WITH EXPOSED OPTICAL OR ELECTRICAL COMPONENTS. DO NOT IMMERSE THE SENSOR IN WATER, SOLVENTS, OR CLEANING SOLUTIONS (THE SENSORS AND CONNECTORS ARE NOT WATERPROOF). DO NOT STERILIZE BY IRRADIATION, STEAM, AUTOCLAVE OR ETHYLENE OXIDE UNLESS OTHERWISE INDICATED IN THE SENSOR DIRECTIONS FOR USE. SEE THE CLEANING INSTRUCTIONS IN THE DIRECTIONS FOR USE FOR ALL MASIMO REUSABLE SENSORS. ■ DO NOT USE DAMAGED PATIENT CABLES. DO NOT IMMERSE THE PATIENT CABLES IN WATER, SOLVENTS, OR CLEANING SOLUTIONS (THE PATIENT CABLE CONNECTORS ARE NOT WATERPROOF). DO NOT STERILIZE BY IRRADIATION, STEAM, AUTOCLAVE OR ETHYLENE OXIDE. ■ DO NOT ATTEMPT TO REPROCESS, RECONDITION OR RECYCLE MASIMO SENSORS OR PATIENT CABLES AS THESE PROCESSES MAY DAMAGE THE ELECTRICAL COMPONENTS, POTENTIALLY LEADING TO PATIENT HARM. NUMERIC DISPLAY - SpO2 Stability of the SpO2 readings may be a good indicator of signal validity. Although stability is a relative term, experience will provide confidence for changes that are artifactual or physiological and the speed, timing, and behavior of each. The stability of the readings over time is affected by the averaging mode being used. The longer the averaging time, the more stable the readings tend to become. This is due to a dampened response as the signal is averaged over a longer period of time than during shorter averaging times. However, longer averaging times delay the response of the oximeter and reduce the measured variations of SpO2 and Pulse Rate. Inaccurate measurements may be caused by: ■ ■ ■ ■ ■ ■
4-4
Elevated levels of Carboxyhemoglobin. Elevated levels of Methemoglobin. Severe anemia. Elevated Total Bilirubin levels. Low arterial perfusion. Motion artifact. Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
operation
4
NUMERIC DISPLAY - PULSE RATE The Pulse Rate displayed on the Rad-8 Pulse Oximeter may differ slightly from the heart rate displayed on ECG monitors due to differences in averaging times. There may also be a discrepancy between cardiac electrical activity and peripheral arterial pulsation. Significant differences may indicate a problem with the signal quality due to physiological changes in the patient or one of the instruments or application of the sensor or patient cable. The pulsations from intra-aortic balloon support can cause the pulse rate displayed on the Rad-8 to be significantly different than the ECG heart rate. NUMERIC DISPLAY - (PI) The perfusion index (PI) bar graph indicator provides a relative numeric indication of the pulse strength at the monitoring site. It is a calculated percentage between the pulsatile signal and non-pulsatile signal of arterial blood moving through the site. PI may be used to find the best perfused site and to monitor physiological changes in the patient. It displays an operating range of 0.02 percent to 20.00 percent. A percentage greater than 1.00 percent is desired. Extreme changes in the display number are due to motion artifact and changes in physiology and blood flow. LOW PERFUSION The instrument indicates perfusion on a 10-bar LED indicator. The lower two segments of the bar will turn red when the amplitude of the arterial pulsations is very low (low perfusion). It has been suggested that at extremely low perfusion levels, pulse oximeters can measure peripheral saturation, which may differ from central arterial saturation1. This “localized hypoxemia” may result from the metabolic demands of other tissues extracting oxygen proximal to the monitoring site under conditions of sustained peripheral hypoperfusion. (This may occur even with a pulse rate that correlates with the ECG heart rate.) CAUTION: IF THE LOW PERFUSION INDICATION IS FREQUENTLY DISPLAYED, FIND A BETTER-PERFUSED MONITORING SITE. IN THE INTERIM, ASSESS THE PATIENT AND, IF INDICATED, VERIFY OXYGENATION STATUS THROUGH OTHER MEANS. 1 Severinghaus JW, Spellman MJ. pulse oximeter Failure Thresholds in Hypotension and Vasoconstriction. Anesthesiology 1990; 73:532-537
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
4-5
4
operation
ACTIONS TO BE TAKEN If the SpO2 readings show significant differences, do the following: ■ Make sure the emitter and detector are aligned directly opposite each other. ■ Select a site where the distance between the emitter and detector is minimized. ■ Wipe the sensor site with a 70% isopropyl alcohol pad or rubefacient cream (10-30% methyl salicylate and 2-10% menthol) for 20-30 seconds. Strong vasodilator creams, such as nitroglycerin paste, are not recommended. ■ If possible, remove electrical noise sources such as electro-surgical units or other electrical/electronic equipment ■ If artificial nails or excessive fingernail polish are present, select another site or remove the polish/artificial nails. ■ If possible, ensure that the sensor is placed in a location with low ambient light. Although the pulse oximeter integrated with Masimo SET technology has significant immunity to ambient light, excessive ambient light may cause readings to be incorrect. CAUTION: IF ANY MEASUREMENT SEEMS QUESTIONABLE, FIRST CHECK THE PATIENT’S VITAL SIGNS BY ALTERNATE MEANS AND THEN CHECK THE PULSE OXIMETER FOR PROPER FUNCTIONING. SIGNAL IQ - (SIQ) The display provides a visual indicator of the plethysmogram signal quality and an alert when the displayed SpO2 values are not based on adequate signal quality. The signal quality indicator displayed is called the Signal IQ. The Signal IQ can be used to identify the occurrence of a patient’s pulse and the associated signal quality of the measurement. The Signal IQ is shown as a “bouncing bar” indicator, where the peak of the bar coincides with the peak of an arterial pulsation. Even with a plethysmographic waveform obscured by artifact, the instrument locates the arterial pulsation. The pulse tone (when enabled) coincides with the peak of the Signal IQ bar. As saturation increases or decreases, the pulse tone will ascend or descend accordingly, for each 1% change in saturation. The height of the Signal IQ bar indicates the quality of the measured signal. A high vertical bar indicates that the SpO2 measurement is based on a good quality signal. A small vertical bar indicates that the SpO2 measurement is based on data with low signal quality. When the signal quality is very low the accuracy of the SpO2 measurement may be compromised. A “Low Signal IQ” is indicated by a bar height of two bars or less and the bars turn red. When this occurs, proceed with caution and do the following: ■ Assess the patient. ■ Check the sensor and ensure proper sensor application. The sensor must be well secured to the site to maintain accurate readings. Also, misalignment of the sensor’s emitter and detector can result in smaller signals. ■ Determine if an extreme change in the patient’s physiology and blood flow at the monitoring site occurred, (e.g. an inflated blood pressure cuff, a squeezing motion, sampling of an arterial blood specimen from the hand containing the pulse oximetry sensor, severe hypotension, peripheral vasoconstriction in response to hypothermia, medications, or a spell of Raynaud’s syndrome.) ■ With neonates or infants, check that the peripheral blood flow to the sensor site is not interrupted. Interruption, for example, as may occur while lifting or crossing their legs, during a diaper change. After performing the above, if the “Low Signal IQ” indication occurs frequently or continuously, obtaining an arterial blood specimen for oximetry analysis may be considered to verify the oxygen saturation value. 4-6
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
operation
4
SENSOR PLACEMENT If the SpO2, readings are questionable or unavailable, do the following: ■ Make sure the emitter and detector are aligned directly opposite each other. ■ Select a site where the distance between the emitter and detector is minimized. ■ Wipe the sensor site with a 70% isopropyl alcohol pad or rubefacient cream (10-30% methyl salicylate and 2-10% menthol) for 20-30 seconds to increase perfusion. However, strong vasodilator creams, such as nitroglycerin paste, are not recommended. ■ If possible, remove electrical noise sources such as electro-surgical devices or other electrical/electronic equipment. If these solutions are not possible, operate the Rad-8 on battery power, or try plugging the instrument into a different electrical outlet. ■ If artificial nails or excessive fingernail polish are present, select another site or remove the polish/artificial nails. ■ If possible, ensure that the sensor is placed in a location with low ambient light. Although the Rad-8 with integrated Masimo SET technology has significant immunity to ambient light, excessive ambient light may cause readings to be incorrect. CAUTION: IF ANY MEASUREMENT SEEMS QUESTIONABLE, FIRST CHECK THE PATIENT’S VITAL SIGNS BY ALTERNATE MEANS AND THEN CHECK THE PULSE OXIMETER FOR PROPER FUNCTIONING. SENSITIVITY The Rad-8 Pulse Oximeter is equipped with 3 different sensitivity modes. Each mode allows the clinician to change the sensitivity settings of the instrument to meet the increased demands of the patient’s physiological condition or enable it to work during periods of low perfusion and/or motion. They are as follows: ■ Normal Sensitivity (NORM) – This is the recommended mode for patients that are experiencing some compromise in blood flow or perfusion. It is advisable for care areas where patients are observed frequently, such as an intensive care unit (ICU). ■ Adaptive Probe Off Detection (APOD) – This is the recommended start-up monitoring mode for most patients with acceptable perfusion or where a more robust sensor off detection is desired. It is the suggested mode for care areas where patients are not visually monitored continuously. This mode delivers enhanced protection against erroneous pulse rate and arterial oxygen saturation readings when a sensor becomes inadvertently detached from a patient. ■ Maximum Sensitivity (MAX) - This mode is recommended for patients with low perfusion or when the low perfusion or low signal quality message is displayed on the screen in APOD or normal sensitivity mode. This mode is not recommended for care areas where patients are not monitored visually, such as general wards. It is designed to interpret and display data at the measuring site when the signal may be weak due to decreased perfusion. When a sensor becomes detached from a patient, it will have compromised protection against erroneous pulse rate and arterial saturation readings. Also, after a power off and on cycle, the sensitivity will change from the MAX to the factory default or user configured default setting of APOD or NORM. CAUTION: WHEN USING THE MAXIMUM SENSITIVITY SETTING, THE PERFORMANCE OF THE SENSOR OFF DETECTION MAY BE COMPROMISED. IF THE INSTRUMENT IS IN THIS SETTING AND THE SENSOR BECOMES DISLODGED FROM THE PATIENT, THE POTENTIAL FOR FALSE READINGS MAY OCCUR DUE TO ENVIRONMENTAL ‘NOISE’ SUCH AS LIGHT, VIBRATION AND EXCESSIVE AIR MOVEMENT. Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
4-7
4
operation
LOW BATTERY AUDIBLE ALARM If a low battery condition occurs during patient monitoring, a low priority alarm will sound, and can be silenced for 120 seconds (default) by pressing the Alarm Silence Button. Refer to Setup Menu Level 2 in this section to change setting. If a low battery condition occurs while not monitoring a patient, a low priority audible alarm will sound and can be silenced by pressing the Alarm Silence Button. The audible alarm is silenced until the power is cycled or patient monitoring begins. While audible alarms are silenced, the first Battery Level Indicator bar to the left flashes green. When a low battery condition occurs, immediately discontinue patient monitoring and plug the Rad-8 into AC power. The AC Power Indicator on the Rad-8 illuminates and remains illuminated while the battery is charging, however, the Battery Charge Level Indicator does not illuminate. Once the battery is fully charged all Battery Charge Level Indicators illuminate green when unplugged. During normal patient monitoring, the Battery Charge Bars (Battery Charge Level Indicator) illuminate green from left to right to indicate the approximate amount of battery charge when unplugged. CAUTION: THE BATTERY SHOULD BE ADEQUATELY CHARGED TO ENSURE BACKUP POWER IN CASE OF AC POWER DISRUPTION.
4-8
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
operation
4
Normal patient monitoring FRONT PANEL CONTROL OPERATION SETUP MENU This section gives an overview of the Rad-8 menu selections available. To access the menu levels and navigate through the menu selections, use the front panel buttons, Enter Button and Up/Down Buttons as indicated in the following sections. Sub-sections describe each menu item in more detail. The Rad-8 has options that allow user configuration to accommodate specific needs. MENU NAVIGATION The Rad-8 set-up and configuration options are accessed through the menu system. Four levels of menus are available to the user. Once a menu level is accessed, a front panel button (Level 1 only) or the Enter Button (Level 2 and 3) is used to move from one option to the next allowing repeated cycling through the options. The Up and Down Buttons are used to adjust values within each option. The parameter/measurement value is set when the Enter Button is pressed. When accessing the Rad-8 menu, each selection will be communicated visually on the LED (front of instrument). NOTE: The Rad-8 will automatically ‘time out’ of any setup menu after 10 seconds if no button is pressed. SETUP MENU LEVEL 1 ALARM LIMITS To access alarm limits for parameters/measurements, press the Alarm Limits Button to access the Alarm Limits menu. BUTTONS
SETTINGS
INSTRUCTIONS
%SpO2 LO
Use the Up Button to move between settings and the Enter Button to accept the setting and move to the next menu screen
Press once
Use the Alarm Limits Button to access the alarm limits options and move between options.
Press 2x %SpO2 HI Press 3x Pulse rate (BPM) LO Press 4x
OR let the instrument time out for 10 seconds to exit without saving the new setting and to return to the home display screen. .
Pulse rate (BPM) HI
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
4-9
operation
4
SETUP MENU LEVEL 1 (CONTINUED) LED BRIGHTNESS The Display screen and all active LED indicators are effected while adjusting this setting. BUTTONS
SETTINGS
INSTRUCTIONS
LED Brightness Level 3 (default) Press 2x
Hold down the Brightness Button for 5 seconds to access LED to brightness options
Press 3x
Press 4x
LED Brightness Level 4
LED Brightness Level 1
Use the Brightness Button to move between menu options and the Enter Button to accept the setting.
LED Brightness Level 2
SETUP MENU LEVEL 2 Level 2 menu contains parameters and settings that are not changed as frequently as Level 1. These include alarm volume, alarm silence, alarm delay, clear trend, button volume, sensitivity, and FastSat parameters. Use the Enter Button to access the menu. Press the Enter Button again to move to the next menu. ALARM VOLUME BUTTONS
SETTINGS
INSTRUCTIONS
Alarm Volume Level 3 (default) Use the Enter Button to access the Alarm Volume menu and to move between Level 2 menus.
Press Up Once
Alarm Volume Level 4
Press Up 2x
Alarm Volume Level 1
Press Up 3x
4-10
Use the Up Button to move between settings and the Enter Button to accept the setting and move to the next menu screen OR let the instrument time out for 10 seconds to exit without saving the new setting.
Alarm Volume Level 2
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
4
operation
SETUP MENU LEVEL 2 (CONTINUED) ALARM SILENCE BUTTONS
SETTINGS Alarm Silence 120 seconds (default)
Press the Enter Button again to move to the next menu.
Press Up Once
Press Up 2x
Press Up 3x
Alarm Silence 30 seconds Alarm Silence 60 seconds Alarm Silence 90 seconds
INSTRUCTIONS
Use the Up or Down Button to move between settings and the Enter Button to accept the setting and move to the next menu screen OR let the instrument time out for 10 seconds to exit without saving the new setting.
ALARM DELAY Alarm delay allows the user to adjust the time in which the audible status indicator will occur after an alarm condition has been initiated. BUTTONS
SETTINGS Alarm Delay 5 seconds (default)
Press the Enter Button again to move to the next menu.
Press Up Once
Press Up 2x
Press Up 3x
Alarm Delay 10 seconds Alarm Delay 15 seconds Alarm Delay 0 seconds
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
INSTRUCTIONS
Use the Up Button to move between settings and the Enter Button to accept the setting and move to the next menu screen OR let the instrument time out for 10 seconds to exit without saving the new setting.
4-11
operation
4
SETUP MENU LEVEL 2 (CONTINUED) CLEAR TREND The Rad-8 only stores data in the trend memory while the instrument is turned on. Trend data saves to the memory until the memory is full or cleared by the user. NOTE: It is recommended that you clear the trend prior to performing a new patient data collection procedure. BUTTONS
Press the Enter Button again to move to the next menu.
SETTINGS
Press Up Once
INSTRUCTIONS
Clear Trend NO (default)
Confirm YES setting and press Enter.
Clear Trend YES
Use the Up or Down Button to move between settings and the Enter Button to accept the setting and move to the next menu screen. OR let the instrument time out for 10 seconds to exit without saving the new setting.
NOTE: The Clear Trend menu is used frequently. As a convenience, the Clear Trend menu may be accessed directly without going through the Setup Level 2 menu structure. (If Clear Trend is directly accessed from Setup Menu Level 2, Setup Menu Level 2 exits to the main display). To access the Clear Trend menu directly, hold down the Enter Button and Brightness Button for 5 seconds. Use the Up or Down Button to move between settings. Confirm the setting and press the Enter Button to accept the new setting. BUTTON VOLUME BUTTONS
SETTINGS Button Volume Level 2 (default)
Press the Enter Button again to move to the next menu.
Press Up Once
Press Up 2x
Press Up 3x
4-12
Button Volume Level 3 Button Volume Level “Off” Button Volume Level 1
INSTRUCTIONS Use the Up or Down Button to move between settings and the Enter Button to accept the setting and move to the next menu screen OR let the instrument time out for 10 seconds to exit without saving the new setting.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
4
operation
SETUP MENU LEVEL 2 (CONTINUED) SENSITIVITY BUTTONS
Press the Enter Button again to move to the next menu.
Press Up Once
SETTINGS
INSTRUCTIONS
Sensitivity APOD (APO) (default)
Use the Up or Down Button to move between settings and the Enter Button to accept the setting and move to the next menu screen
Sensitivity NORM (NOr)
OR
Press Up 2x Sensitivity MAX
let the instrument time out for 10 seconds to exit without saving the new setting.
FASTSAT BUTTONS
SETTINGS FastSat Off (Default)
Press the Enter Button again to move to the next menu. Press Up Once
Use the Up or Down Button to move between settings and the Enter Button to accept the setting and move to the next menu screen OR
FastSat On
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
INSTRUCTIONS
let the instrument time out for 10 seconds to exit without saving the new setting.
4-13
4
operation SETUP MENU LEVEL 3 (ENTER BUTTON + DOWN BUTTON MENU SETTINGS) Setup Menu Level 3 contains advanced parameter/measurement settings. To access Level 3 parameters/measurements, hold down the Enter Button and press the Down Button for 5 seconds. After entering menu Level 3, use the Up or Down button to move between settings. Press the Enter Button to save new settings and move to the next menu. The user cycles through the menu options by continuing to press the Enter Button. AVERAGING TIME BUTTONS
SETTINGS
INSTRUCTIONS
Averaging Time 8 seconds (default, except in Sleep Mode) Press Up Once
Hold down Enter Button and Down Button for 5 seconds.
Press Up 2x
Press Up 3x
+ Press Up 4x
Press Up 5x
Press Up 6x
4-14
Averaging Time 10 seconds Averaging Time 12 seconds
Use the Up or Down Button to move between settings AND press the Enter Button to accept the setting and move to the next menu option OR
Averaging Time 14 seconds Averaging Time 16 seconds Averaging Time 2 seconds
let the instrument time out for 10 seconds to exit without saving the new setting. NOTE: If the instrument is in the Sleep Mode, averaging time automatically reverts to 2 seconds.
Averaging Time 4 seconds
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
4
operation
SETUP MENU LEVEL 3 - (CONTINUED) RAPID DESAT LIMIT The Rapid Desat Limit is designed to detect rapid desaturations of 5%, 10%, or 0% below the low alarm limit and overrides the Alarm Delay feature when activated. BUTTONS
Press the Enter Button again to move to the next menu.
SETTINGS
Press Up Once
INSTRUCTIONS
Rapid Desat Limit 5% (default)
Use the Up or Down Button to move between settings
Rapid Desat Limit 10%
press the Enter Button to accept the setting and move to the next menu.
AND
OR Press Up 2x
Rapid Desat Limit 0%
let the instrument time out for 10 seconds to exit without saving the new settings.
ALARM ON/OFF BUTTONS
SETTINGS Alarm On/Off (Default ON)
Press the Enter Button again to move to the next menu.
Press Up Once
Press Up 2x
Alarm On/Off* OFF
Alarm Off (rE)** (Alarm OFF with reminder)
INSTRUCTIONS Use the Up or Down Button to move between settings AND press the Enter Button to accept the setting and move to the next menu OR let the instrument time out for 10 seconds to exit without saving the new setting.
* Visual alarms are active in this mode. **When Alarm On/Off is set to "Off rE", the audible alarm "beeps" twice every three minutes to remind the user that the Rad-8 is currently in alarm status but the audible alarm is muted. Visual alarms are active in this mode. If an alarm limit is violated, the associated parameter/measurement label and value flash, the alarm bell flashes red for high priority alarms.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
4-15
4
operation
SETUP MENU LEVEL 3 - (CONTINUED) DEFAULT SETTINGS BUTTONS
SETTINGS
INSTRUCTIONS
Default Settings*
Use the Up or Down Button to move between settings
No Change (default) Press the Enter Button again to move to the next menu.
Press Up once
Default Settings User Default*
Press Up 2x
Default Settings Factory Default (Restores factory default settings)
AND press the Enter Button to accept the setting and move to the next menu OR let the instrument time out for 10 seconds to exit without saving the new setting.
NOTE: The Default Settings menu is used frequently. As a convenience, the Default Settings menu may be accessed directly without going through the Setup Menu Level 3 structure. (If Default Settings is directly accessed from Setup Menu Level 3, Setup Menu Level 3 exits to the main display). To access the Default Settings menu directly, hold down the Enter Button for 5 seconds. Use the Up or Down Button to move between settings. Press the Enter Button to accept the setting. * Locks in current settings as new default setting. With this setting, the LED light by the alarm limits button goes off because these settings use the factory default feature to restore factory settings.
SMART TONE ON/OFF The SmartTone feature uses a proprietary algorithm that will provide pulse tones during excessive motion and low perfusion conditions. The pulse tone is based on an averaged pulse rate measurement from the proprietary algorithm and may not identify irregular heart beat patterns when there is excessive artifact present. The Normal Tone feature uses a proprietary algorithm that will provide pulse tones during non motion and adequate perfusion conditions. In this mode, the pulse tone may not sound if excessive artifact is present. BUTTONS
SETTINGS
INSTRUCTIONS
SmartTone
Use the Up or Down Button to move between settings
OFF (default) (Normal Tone)
Press the Enter Button again to move to the next menu. Press Up Once
SmartTone ON (Smart Tone)
4-16
AND press the Enter Button to accept the setting and move to the next menu OR let the instrument time out for 10 seconds to exit without saving the new setting.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
4
operation
SETUP MENU LEVEL 3 - (CONTINUED) YEAR BUTTONS
Press the Enter Button again to move to the next menu.
SETTINGS
Press Up Once and press Enter
INSTRUCTIONS
Year (current year)
Confirm setting and press Enter.
(default set to internal clock)
NOTE: Pressing Enter while on Yes will clear trend.
Year Sets year (0-99)
Use the Up or Down Button to move between settings. AND press the Enter Button to accept the setting and move to the next menu
Press Up Once and press Enter
Year (defaults to Yes)
OR let the instrument time out for 10 seconds to exit without saving the new setting.
MONTH BUTTONS
Press the Enter Button again to move to the next menu.
SETTINGS
INSTRUCTIONS
Month (current month)
Confirm setting and press Enter.
(default set to internal clock)
NOTE: Pressing Enter while on Yes will clear trend.
Month
Use the Up or Down Button to move between settings
Press Up Once and press Enter
Sets Month (0-12)
Press Up once and press Enter
Month (defaults to Yes)
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
AND press the Enter Button to accept the setting and move to the next menu OR let the instrument time out for 10 seconds to exit without saving the new setting.
4-17
operation
4
SETUP MENU LEVEL 3 (CONTINUED) DAY BUTTONS
SETTINGS Day (current day) (default is set to internal clock)
Press the Enter Button again to move to the next menu.
Press Up Once and press Enter
Day Sets Day (0-31)
INSTRUCTIONS Confirm setting and press Enter. NOTE: Pressing Enter while on Yes will clear trend. Use the Up or Down Button to move between settings AND press the Enter Button to accept the setting and move to the next menu
Press Up Once and press Enter Day (defaults to Yes)
OR let the instrument time out for 10 seconds to exit without saving the new setting.
HOUR BUTTONS
SETTINGS Hour (defaults is set to internal clock)
Press the Enter Button again to move to the next menu.
Press Up Once and press Enter
Hour Sets Hour (0-23)
Press Up Once and press Enter
Hour (defaults to Yes)
4-18
INSTRUCTIONS Confirm setting and press Enter. NOTE: Pressing Enter while on Yes will clear trend. Use the Up or Down Button to move between settings AND press the Enter Button to accept the setting and move to the next menu OR let the instrument time out for 10 seconds to exit without saving the new setting.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
4
operation
SETUP MENU LEVEL 3 (CONTINUED) MINUTE BUTTONS
SETTINGS Minute (current minute)
Press the Enter Button again to move to the next menu.
INSTRUCTIONS Confirm setting and press Enter.
(default is set to internal clock)
NOTE: Pressing Enter while on Yes will clear trend.
Minute
Use the Up or Down Button to move between settings
Sets Minute (00-59)
AND
Press Up Once and press Enter
Press Up Once and press Enter
Minute (defaults to Yes)
press the Enter Button to accept the setting and move to the next menu OR let the instrument time out for 10 seconds to exit without saving the new setting.
SOFTWARE VERSION BUTTONS
SETTINGS
INSTRUCTIONS
Software Version:
Use the Up or Down Button to move between settings
System Software (default)
Press the Enter Button again to move to the next menu. Press Up Once
Software Version: SET Software
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
AND press the Enter Button to accept the setting and move to the next menu OR let the instrument time out for 10 seconds to exit without saving the new setting.
4-19
4
operation
SETUP MENU LEVEL 3 (CONTINUED) SERIAL OUTPUT BUTTONS
SETTINGS Serial Output (SEr) (default is set to ASCII 2)
Press the Enter Button again to move to the next menu.
Press Up Once
Press Up 3x
Use the Up or Down Button to move between settings AND
Serial Output ASCII 2 (AS2)
Press Up 2x
INSTRUCTIONS
Serial Output ASCII 1 (AS1) Serial Output Philips Vuelink (PHL)
press the Enter Button to accept the setting and move to the next menu OR let the instrument time out for 10 seconds to exit without saving the new setting.
INTERFACE ALARMS When Rad-8 is interfaced to another system, audible alarms are muted at the interfaced monitor. When the Interface Alarms feature is set to “Off”, SpO2 and BPM audible alarms are muted at the Rad-8. Visual alarms are active in this mode, and the Alarm Bell indicator light flashes. Once the SpO2 and/or BPM alarm condition is resolved and there are no other system or parameter/measurement alarms, the Alarm Bell stops flashing. CAUTION: WHEN THE INTERFACE ALARMS FEATURE IS SET TO “OFF”, THE AUDIBLE ALARMS AT THE INTERFACED SYSTEM ARE ALSO MUTED. IF THE INTERFACED SYSTEM IS CONNECTED TO A CENTRAL MONITORING SYSTEM, AUDIBLE ALARMS WILL BE ACTIVE AT THE CENTRAL MONITOR. NOTE: The Rad-8 reverts to Interface Alarms "On" during power interruptions or when the interface connection is lost. This ensures that the Rad-8 provides SpO2 and BPM audible alarms when connection to the interfaced system becomes compromised. BUTTONS
SETTINGS Interface Alarms (default is set to On)
Press the Enter Button again to move to the next menu.
Press Up Once
Interface Alarms On
INSTRUCTIONS Use the Up or Down Button to move between settings AND press the Enter Button to accept the setting and move to the next menu OR
Press Up 2x
Interface Alarms Off
4-20
let the instrument time out for 10 seconds to exit without saving the new setting.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
4
operation
SETUP MENU LEVEL 3 (CONTINUED) NURSE CALL BUTTONS
SETTINGS
INSTRUCTIONS
Nurse Call (default is set to Alarms only) Press the Enter Button again to move to the next menu.
Press Up Once
Nurse Call Alarms Only
Press Up 2x
Nurse Call SIQ only
Press Up 3x
Nurse Call
Use the Up or Down Button to move between settings AND press the Enter Button to accept the setting and move to the next menu option OR let the instrument time out for 10 seconds to exit without saving the new setting.
Alarms and SIQ
POLARITY BUTTONS
SETTINGS Nurse Call Polarity
Press the Enter Button again to move to the next menu.
(default is set to Normal) Press Up Once
Nurse Call Polarity Normal
Press Up 2x
Nurse Call Polarity Inverse
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
INSTRUCTIONS Use the Up or Down Button to move between settings AND press the Enter Button to accept the setting and move to the next menu option OR let the instrument time out for 10 seconds to exit without saving the new setting.
4-21
operation
4
SETUP MENU LEVEL 4 (ENTER BUTTON + UP BUTTON MENU SETTINGS) Level 4 parameter/measurements sets up the instrument for Standard, Sleep, or Home mode operation. To access Level 4 parameters/measurements, hold down the Enter Button and press the Up Button for 5 seconds. After entering menu Level 4, use the Up or Down button to move between settings. Press the Enter Button to save new settings and move to the next menu. SET MODE BUTTONS
SETTINGS Set Mode
Hold down Enter Button and Up Button for 5 seconds.
(default is set to Standard) Press Up Once
+ Press Up 2x
INSTRUCTIONS Use the Up or Down Button to move between settings AND
Set Mode Sleep*
press the Enter Button to accept the setting OR
Set Mode Home
let the instrument time out for 10 seconds to exit without saving the new setting.
* Sleep mode automatically defaults to 2 second averaging time. Coming out of the Sleep mode returns the user to originally set averaging time.
System interfaces PHILIPS VUELINK SETUP 1. Select the Philips VueLink selection from the Serial Output menu on the Rad-8. After selecting, choose the preferred settings by stepping through menu options. 2. Connect one end of the VueLink cable to the Serial Output connector on the back of the Rad-8. 3. Connect the other end of the VueLink cable to the VueLink module and insert the module into the Philips/Agilent monitor rack. 4. The SpO2 and pulse rate values will automatically appear on the HP/Agilent monitor. 5. In order for the pleth waveform to be displayed on the Philips/Agilent monitor and for the Philips/Agilent monitor to indicate the alarm conditions measured by the pulse oximeter, the user must configure the Philips/Agilent monitor. Please see the Philips/Agilent Operator’s manual for complete instructions. 6. The Rad-8 Pulse Oximeter can be set up to audibly indicate all patient alarms while communicating with the Philips/ VueLink module. Use the Interface Alarms setting in the Output menu to enable and disable audible alarms on the Rad-8. PATIENT SAFETY NET/RADNET SETUP Refer to the Patient Safety Net/RadNet Directions for Use for setup information.
4-22
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
operation
4
Trend Setup and Use INTRODUCTION The Rad-8 can store up to 72 hours of trend data captured at 2 second intervals. The trend data can then be transferred to a PC for evaluation. A serial cable is required to connect the Rad-8 to a PC. Patient monitoring is not possible while trend memory is being transferred to a PC. Trend data is stored in non-volatile memory, so it is not erased when the instrument is shut off. A trend data download is initiated using the TrendCom utility which downloads the trend data and saves it to an ASCII text (.out) file with an output delimiter option. NOTE: Rad-8 Serial Output must be set to ASCII 2 for successful download of trending data. Refer to the Serial Output settings, Setup Menu Level 3, in this section. TRENDCOM UTILITY INSTALLATION Copy the TrendCom utility from the TrendCom CD onto a PC running MS-Windows. TRENDCOM UTILITY OPERATION NOTE: During download of trend information, all normal Rad-8 functions are unavailable and the keypad is locked, except for the power button. NOTE: If your PC is unable to recognize the USB to Serial port adapter, contact USB to serial port adapter manufacturer for assistance or support. 1. 2. 3. 4. 5. 6. 7. 8.
Turn Rad-8 off if not already off. Connect serial cable to Rad-8 and other end to a com port on the PC. Turn the Rad-8 on. Start the TrendCom utility on the PC. Select Rad-8 from the first pull-down menu. Select the appropriate com port number from the second pull-down menu, if necessary. Select the Output Delimiter Option (Tab, Comma or Space). Select the RETRIEVE TREND button on the TrendCom utility. Select the desired location and assign a file name for the trend file. Select SAVE. 9. The Rad-8 will display “dat out” while trend data is being transferred. A progress bar will advance to indicate the status of the download. Larger trend files will take longer to download. Transfer time is approximately 20 seconds per hour of trend data. 10 When trend data transfer is complete, close TrendCom and disconnect the Rad-8 from the serial cable. 11. Turn the Rad-8 off to exit the trend download mode. ERASING TREND MEMORY To erase (clear) the trend memory, set the Clear Trend option to Yes and press the Enter Button to accept the setting and clear the data from the memory. Refer to the Clear Trend menu located before this Trend setup and use section. The Rad-8 continuously trends data. When performing a new study and gathering data on a new patient, it is highly recommended the "clear function" be utilized in order for the results to be separate. Turning the Rad-8 off will not erase the trend data.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
4-23
operation
4
TREND DATA FORMAT After a successful download of the trend data, a .out file will be created containing the trenddump information in ASCII delimited format. The format is defined in the following table. PARAMETER
SPECIFICATION
Date
MM\DD\YY
Time
HH:MM:SS
Installed Parameter/ Measurement
Numeric value (see the display ranges in the Factory and User Configurable Default Settings table located at the beginning of this section)
Exception Messages
The exceptions are displayed as a 3 digit, ASCII encoded, hexadecimal value. The binary bits of the hexadecimal value are encoded as follows: 000 = Normal operation; no exceptions 001 = No Sensor 002 = Defective Sensor 004 = Low Perfusion 008 = Pulse Search 010 = Interference 020 = Sensor Off 040 = Ambient Light 080 = Unrecognized Sensor 100 = reserved 200 = reserved 400 = Low Signal IQ 800 = Masimo SET. This flag means the algorithm is running in full SET mode. It requires a SET sensor and needs to acquire some clean data for this flag to be set
SAMPLE TREND OUTPUT 09/21/08 09/21/08 09/21/08 09/21/08 09/21/08 09/21/08 09/21/08 09/21/08
4-24
09:56:08 09:56:10 09:56:12 09:56:14 09:56:16 09:56:18 09:56:20 09:56:22
SpO2=000 SpO2=000 SpO2=097 SpO2=096 SpO2=098 SpO2=000 SpO2=000 SpO2=096
PR=000 PR=000 PR=069 PR=074 PR=078 PR=000 PR=000 PR=078
PI=00.00 PI=00.00 PI=04.69 PI=02.28 PI=03.64 PI=00.00 PI=00.00 PI=02.68
EXC=820:OffPat,SET EXC=828:Search,OffPat,SET EXC=800:SET EXC=C00:LowSigIQ,SET EXC=800:SET EXC=800:SET EXC=820:OffPat,SET EXC=800:SET
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
operation
4
HOME MODE OPERATION The instrument can be placed into the Home Mode to protect unqualified users from changing the alarm settings and operation. Only the following menu and front panel functions are available: display brightness, pulse beep volume adjustment, and alarm suspend. Alarm volume is at highest setting. All default and user defined default settings are locked to their current values when home mode is selected and return to those values after a power cycle. Upon power up, the Hmm mode will be displayed along with a 10 second display of parameters. To turn the instrument off the power key must be depressed and held for 3 seconds. The Mode Enter and Up Button held simultaneously for 3 second will put it back into the special menu to select a different mode. SLEEP MODE OPERATION The instrument can be placed into the Sleep Mode (SLP) to allow the instrument to capture normal and abnormal patient data without triggering the alarms. This mode will blank out the instrument display with the exception of the Battery Level Indicator and the Alarm Silenced Indicator and disable the alarms even after a power cycle. However, any single key press will bring the display back for 10 seconds. Upon power up, the SLP mode will be displayed along with a 10 second display of parameter settings. The Sleep mode automatically defaults to 2 second averaging time. Coming out of the Sleep mode returns the user to orginally set averaging time. The Mode Enter and Up Button held simultaneously for 3 seconds (select next (STD), Mode Enter) will put it back into the special menu to exit. CAUTION: ALARMS ARE DISABLED IN THIS MODE. NOTE: If the instrument is connected to a Patient Safety Net system, there will be no communication with the Patient Safety Net in Home and Sleep mode.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
4-25
5
messages Alarm identification The instrument visually and audibly indicates alarm conditions that the system detects. Audible alarms may be silenced, without affecting the operation of visual alarms. The following table outlines the alarm priority specifications. ALARM PRIORITY
PARAMETER
ALARM TYPE
Low arterial oxygen saturation System failures High
High pulse rate Low pulse rate
Audible and visual
Sensor off and no sensor Low
Low battery High saturation
CAUTION: FOR HOME USE, ENSURE THAT THE RAD-8 ALARM CAN BE HEARD FROM OTHER ROOMS IN THE HOUSE ESPECIALLY WHEN NOISY APPLIANCES SUCH AS VACUUM CLEANERS, DISHWASHERS, CLOTHES DRYERS, TELEVISIONS, OR RADIOS ARE OPERATING. Alarm indication An alarm condition is indicated by: ■ Audible alarm tone ■ Visual Alarm Indicator (Alarm bell) ■ Out-of-limit parameter will flash The “no sensor” and “sensor off” indication will only generate an alarm condition after a pulse has been found.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
5-1
5
messages Alarm limits CAUTION: TO ENSURE THAT ALARM LIMITS ARE APPROPRIATE FOR THE PATIENT BEING MONITORED, CHECK THE LIMITS EACH TIME THE RAD-8 IS USED. When an alarm limit is exceeded, an audible alarm activates and the Alarm Bell flashes red for high priority alarms. When a sensor is not connected to a patient, “SEN OFF” message will show on the display. When a sensor is not connected to its cable, “NO SEN” message will show on the display. NOTE: An audible alarm will accompany the visual indicators unless the Rad-8 has been set to Interface Alarms "Off" (only SpO2 and BPM alarms muted) or to Sleep Mode (all alarms muted). SETTING
RANGE
SpO2 High Limit
The SpO2 high alarm limit can be set anywhere between 2% and 99%, then “----” (Off), with a 1% step size. In the “----” (Off) setting, the SpO2 High Limit alarm is disabled.
SpO2 Low Limit*
The SpO2 low alarm limit can be set anywhere between 1% and 98%, with a 1% step size.
Pulse Rate High Limit (BPM)
The pulse rate high alarm limit can be set anywhere between 35 BPM and 235 BPM, with a 5 BPM step size..
Pulse Rate Low Limit (BPM)*
The pulse rate low alarm limit can be set anywhere between 30 BPM and 230 BPM, with a 5 BPM step size.
* The low alarm limit must always be set below the high alarm setting. Attempting to set the high alarm limit below the low alarm limit, the low alarm limit will automatically adjust the low limit to the next setting below the newly entered high alarm limit setting.
NOTE: Pressing and holding down the up and down buttons allow for the rapid scrolling of changing SpO2 and BPM alarm limits. NOTE: If there is a loss of power for any length of time, the Alarm settings will be set back to the User set defaults. If the user has not utilized this option, then they will be set back to the factory defaults.
5-2
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
messages
5
ALARM SILENCE Audible alarms may be silenced, while visual alarms remain active. The alarm silence function is controlled by pressing the Alarm Silence Button. The Alarm Bell provides visual feedback when the Rad-8 audible alarms are silenced. Alarm Silence function when monitoring a patient: Power-On – Alarms active, Alarm Bell flashes red for high priority alarms Press Once – Alarm suspended for 120 seconds. Audible alarms are silenced. The Alarm Bell flashes red for high priority alarms. Press Twice - Returns to audible alarms active. Audible alarms return, Repeated pressing of the Alarm Silence Button will cycle through alarm silence options above. Alarm Silence function when not monitoring a patient: Power-On – Alarms active, Alarm Bell is not flashing. Press Once – Instrument is silenced until it is cycled off/on or until monitoring begins. The Alarm Bell is not flashing ALARM BELL The Alarm Bell flashes red for high priority alarms. Pressing the Alarm Silence Button once silences the audible alarm for 120 seconds (default) while the Alarm Bell flashes to indicate an alarm condition. If the high priority alarm condition is resolved during the Alarm silence interval, the Alarm Bell stops flashing. If the high priority alarm condition remains (Alarm Bell flashing red), pressing the Alarm Silence button again activates the audible alarms and the Alarm Bell continues to flash red. The Alarm Bell stops flashing when the high priority alarm conditions are resolved. ALARM ON/OFF Alarm OFF: All audible alarms are muted and visual alarms are active. Audible alarms are restored when power is turned off and back on. Alarm Off (re): Audible alarms are muted, but the alarm “beeps” twice every three minutes to remind the user that the Rad-8 is currently in an alarm status but that the audible alarm is muted. Visual alarms are active in this mode. If the alarm is violated, the associated parameter/measurement label and value flash, and the alarm bell flashes red for high priority alarms. Audible alarms are restored when power is turned off and back on.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
5-3
messages
5
MESSAGES The Rad-8 will indicate other data or system errors. Message conditions are as follows: DISPLAY THREE DASHES (“---”)
TYPE Calibration and Pulse Search
SOLUTION Wait for found pulse. (This search should occur whenever a sensor is first applied to a patient). 1. Rule out occlusion of blood flow. 2. Verify placement of sensor.
PULSE BAR (SIQ) TURNS RED
Low Signal IQ
3. Re-apply sensor or move to a different site. 4. Replace sensor or cable. 1. Rule out occlusion of blood flow. 2. Attempt to warm patient.
PERFUSION BAR (PI) TURNS RED
Low Perfusion
3. Move sensor to better perfused site. NOTE: Masimo recommends using an adhesive sensor whenever low perfusion is expected or evident.
PARAMETER/MEASUREMENT LABEL AND NUMBER FLASH
Alarm Limit Exceeded
Assess /address patient condition. Re-set alarm limits if indicated. Return for service.
System Fault
5-4
There are several error codes. All error codes require return of the instrument to an authorized service center for repair. See Section 9, Service and Repair.
Defective Sensor
Replace sensor.
Unrecognized Sensor
Connect appropriate sensor.
Interference Detected
Ensure that the sensor is properly applied, and cover the sensor site with opaque material, if required.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
messages
5
MESSAGES (CONTINUED) DISPLAY
SINGLE BATTERY LEVEL INDICATOR FLASHES (WITH AUDIBLE ALARM)
TYPE
SOLUTION
No Sensor Connected
Connect sensor to cable.
Sensor off patient
1. Reattach sensor to patient.
Battery level too low
Connect instrument to AC Power to charge the battery.
No Cable Connected
Connect appropriate cable to instrument.
Defective cable
Replace cable
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
2. Verify proper sensor placement.
5-5
6
troubleshooting
Troubleshooting The following chart describes what to do if the Rad-8 system does not operate properly or fails. PROBLEM
POSSIBLE CAUSE(S)
RECOMMENDATION
INSTRUMENT DOES NOT POWER ON
Low battery/ not plugged into AC power supply
Connect the AC Power Cord to the Rad-8 and to an AC outlet. Make sure that the AC Power Indicator light is on.
BATTERY RUN-TIME IS SIGNIFICANTLY REDUCED
Low battery
Contact Technical Services or your local Masimo representative. Instrument requires service. Press the Alarm Silence Button. If alarm continues to sound, power down instrument. If the power button does not turn the instrument off, press and hold the Power Button for 5 seconds. Return the instrument for service. Press Up Arrow or Alarm Volume Adjust.
CONTINUOUS SPEAKER TONE
Internal Failure
NO SPEAKER TONE
Pulse tone set to “mute”
NO ALARM TONE
Alarm Silence Enabled
See Section 4, Alarm Silence.
Sensor not connected to patient properly.
Properly reapply the sensor on the patient and reconnect the sensor to the instrument or patient cable.
SENSOR OFF MESSAGE
NO SENSOR MESSAGE
LOW PERFUSION (PI BAR TURNS RED)
LOW SIGNAL QUALITY
Sensor is damaged.
If the sensor is damaged, replace the sensor.
Sensor is disconnected from patient cable.
Check to see if the sensor LED is flashing. Disconnect and reconnect the sensor. If the LED fails to operate, replace the sensor.
Sensor connected upside down into patient cable. Improper sensor type. Poorly perfused site. Sensor is too tight. A disorder such as hypothermia, vasoconstriction, hypovolemia, peripheral vascular disease or anemia. Sensor is damaged.
Verify proper sensor and sensor size for the patient.
Improper sensor type or application. Excessive motion relative to perfusion, or poor perfusion. Sensor or cable is damaged or not functioning.
Check and see if blood flow to the site is restricted. Check the placement of the sensor. Re-apply sensor or move to a different site. Replace sensor or cable.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
Check and see if blood flow to the site is restricted. Be sure that the sensor is not on too tight. Set the instrument to MAX sensitivity. Warm the patient or sensor site. Move sensor to better perfused site.
6-1
6
troubleshooting Troubleshooting continued PROBLEM
POSSIBLE CAUSE(S)
SpO2 VALUES DO NOT CORRELATE WITH CLINICAL ASSESSMENT OR ABGs
Low perfusion or sensor displacement.
PULSE SEARCH MESSAGE OR “----”
Instrument is searching for pulse.
UNEXPECTED SpO2 READING
RECOMMENDATION Check for error messages. See section 5 Messages for recommended corrections. Check placement of sensor or if it is too tight. Reapply sensor or select a new site. Set to MAX sensitivity and confirm that the sensor is securely on the patient. Refer to sensor Directions For Use. If instrument fails to display within 30 seconds, disconnect and reconnect sensor to patient. If pulse search continues, move sensor to better perfused site.
Low SIQ or Perfusion Index (PI) values.
Reposition sensor to site with strong SIQ and PI. Submit blood sample for laboratory oximetry test for comparison.
Inappropriate sensor size or sensor measurement location.
Verify proper sensor for patient size. Verify proper sensor site.
Low battery/not plugged into AC power supply.
Connect the AC Power Cord to the Rad-8 and to an AC outlet. Make sure that the AC Power Indicator light is on.
DIFFICULTY OR NO SpO2 Inappropriate sensor or sensor size. READING Excessive ambient or strobing light.
Verify proper sensor and sensor size for the patient. Shield the sensor from excessive or strobing light.
Also, see Section 4, Successful Monitoring, for additional information. PRINT FUNCTION DOES NOT WORK
6-2
Wrong serial cable is used. Make sure a null modem cable is used.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
7
specifications Rad-8 specifications PERFORMANCE Measurement Range Arterial Oxygen Saturation (%SpO2): Pulse Rate:
1-100% 25-240 beats per minute (bpm)
Perfusion Index
0.02% - 20%
Response time:
<1 second delay
ACCURACY Arterial Oxygen Saturation Accuracy1 Saturation No Motion2 Infants, Pediatrics Saturation No Motion3 Adults, Infants, Pediatrics Neonates Motion4 Adults, Infants, Pediatrics, Neonates Low Perfusion5 Adults, Infants, Pediatrics Neonates Pulse Rate Accuracy6 Pulse Rate: No Motion Adults, Infants, Pediatrics, Neonates Motion5 Adults, Infants, Pediatrics, Neonates Low Perfusion Adults, Infants, Pediatrics, Neonates Resolution Arterial Oxygen Saturation (%SpO2) Pulse Rate
60% to 80% ±4% 70% to 100% ± 2% ± 3% ± 3% ± 2% ± 3% 25 - 240 (bpm) ± 3 bpm ± 5 bpm ± 3 bpm
1% 1 bpm
ELECTRICAL AC Power requirements: Power consumption:
100-240 VAC, 47-63 Hz 20 VA max.
Battery Type: Capacity: (battery life) Charging time:
Sealed lead acid up to 7 hours7 8 hours
ENVIRONMENTAL Operating Temperature: Transportation/Storage Temperature:
41°F to 104°F (5°C to 40°C) -40°F to 158°F (-40°C to +70°C)8
Storage Humidity:
5% to 95%, non-condensing
Operating Altitude:
500 mbar to 1060 mbar pressure, -1000 ft to 18,000 ft (-304 m to 5,486 m)
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
7-1
7
specifications Rad-8 specifications continued PHYSICAL CHARACTERISTICS Dimensions: Weight:
8.2” x 6.0” x 3.0” (20.8 cm x 15.2cm x 7.6 cm) 2.1 lbs. = .908 Kg. = 32 oz
Trending 72 hours of trending at 2 second resolution Mode Averaging mode: Sensitivity:
2, 4, 8,10, 12, 14 or 16 seconds9 Normal, Maximum, and APOD
Alarms Audible and visual alarms for high and low saturation and pulse rate (SpO2 range 1-99%, pulse rate range 30-235 bpm) Sensor condition, system failure and low battery alarms 800 Hz tone, 5 pulse burst, pulse spacing: 0.250s, High Priority Audible Alarm 0.250s, 0.500s, 0.250s, repeat time:10s Low Priority Audible Alarm
500 Hz tone, 3 pulse, repeat time: 5s
High Priority Visual Alarm
Red flashing 2 seconds (0-5 Hz)
Alarm Volume:
High: 85 dB (min) Low: 45 dB (min)
Display/Indicators
Data display: %SpO2, pulse rate, alarm status, alarm silenced status, AC power, Signal IQ/pleth bar, perfusion index bar, battery status Type: Display update rate
LED 1 second
Output Interface Serial RS-232, Philips VueLink, Nurse Call Compliance Safety Standard for Medical Equipment
IEC 60601-1 2nd Edition UL 60601-1 CAN/CSA C22.2 No. 601-1 JIS 0601-1
Type of Protection Degree of Protection-Patient Cable: Rad-8 Mode of Operation: EMC Standard
Class 1 (AC power), Internally powered (battery power) Type BF, Defib Proof -Applied Part Continuous EN60601-1-2, Class B
1 SpO2 was determined by testing on healthy adult volunteers in the range 60%-100% SpO2 against a laboratory CO-Oximeter. SpO2 accuracy was determined on 16 neonatal NICU patients ranging in age from 7 to 135 days old and weighting between 0.5 and 4.25 kgs. Seventy-nine (79) data samples were collected over a range of 70 - 100% SaO2 with a resultant accuracy of 2.9% SpO2.. Contact Masimo for testing specifications. 2. The arterial oxygen saturation accuracy during no motion only applies to LNOP® Blue SpO2 adhesive sensors.
7-2
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
7
specifications Rad-8 specifications continued 3 Masimo SET technology with LNOP Adt sensors has been validated for motion accuracy in human blood studies on healthy adult male and female volunteers with light to dark skin pigmentation in induced hypoxia studies while performing rubbing and tapping motions, at 2 to 4 Hz at an amplitude of 1 to 2 cm and a non-repetitive motion between 1 to 4Hz at an amplitude of 2 to 3 cm in induced hypoxia studies in the range of 70-100% SpO2 against a laboratory CO-Oximeter and ECG monitor. This variation equals plus or minus one standard deviation which encompasses 68% of the population. The saturation accuracy of the neonatal sensors were validated on adult male and female volunteers with light to dark skin pigmentation and 1% was added to account for the properties of fetal hemoglobin. 4 The Masimo sensors have been validated for motion accuracy in human blood studies on healthy adult male and female volunteers with light to dark skin pigmentation in induced hypoxia studies while performing rubbing and tapping motions, at 2 to 4 Hz at an amplitude of 1 to 2 cm and a non-repetitive motion between 1 to 5 Hz at an amplitude of 2 to 3 cm in induced hypoxia studies in the range of 70-100% SpO2 against a laboratory CO-Oximeter and ECG monitor. This variation equals plus or minus one standard deviation. Plus or minus one standard deviation encompasses 68% of the population. 5 Masimo SET technology has been validated for low perfusion accuracy in bench top testing against a Biotek Index 2 simulator and Masimo’s simulator with signal strengths of greater than 0.02% and a % transmission of greater than 5% for saturations ranging from 70 to 100%. This variation equals plus or minus one standard deviation which encompasses 68% of the population. 6 Masimo sensors have been validated for pulse rate accuracy for the range of 25-240 bpm in bench top testing against a Biotek Index 2 simulator. This variation equals plus or minus one standard deviation which encompasses 68% of the population. 7 Battery capacity varies based on instrument settings. 8. If the batteries are to be stored for extended periods of time, it is recommended that they be stored between -20°C to +30°C, and at a relative humidity less than 85%. If stored for a prolonged period at environmental conditions beyond these limits, overall battery capacity may be diminished, and lifetime of the batteries may be shortened. 9. With FastSat the averaging time is dependent on the input signal. For the 2 and 4 second settings the averaging time may range from 2-4 and 4-6 seconds, respectively.
Serial interface specifications The digital interface for serial communication is based on the standard RS-232 protocol. The Rad-8 Pulse Oximeter by default always outputs ASCII2 text data through the serial port, unless the user selects a different output mode in the Output menu. To interface with the Rad-8 and receive serial text data, simply connect a serial interface cable to the serial output connector located on the back of the Rad-8. NOTE: Trend data packets are collected at 2 second intervals. Each data packet contains: the date, time, SpO2, pulse rate, perfusion index and alarm and exception values (in ASCII format). SERIAL INTERFACE SETUP To interface with the Rad-8 serial port, set the following communication parameters on the interfacing serial device: PARAMETER BAUD RATE NUMBER OF BITS PER CHARACTER PARITY BITS HANDSHAKING CONNECTOR TYPE
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
SETTING 9600 Baud bi-directional 8 None 1 start, 1 stop None Female DB-9
7-3
7
specifications
SERIAL INTERFACE SETUP (CONTINUED) The pin-outs for the RS-232 connector are shown in the following table: PIN
SIGNAL NAME
1
No Connection
2
Receive data – RS-232 ±9 V (±5 Vmin)
3
Transmit data – RS-232 ±9 V (±5 Vmin)
4
No Connection
5
Signal Ground Reference for COM signals
6
No Connection
7
No Connection
8
No Connection
9
No Connection
SERIAL PRINTER SETUP To print the SpO2 and pulse rate data in ASCII1 format on a serial printer, simply connect the laser printer to the serial port and set output mode to ASCII1. Once serial communication is established, the Rad-8 automatically will start printing the ASCII1 text data. WARNING: ALL EXTERNAL INSTRUMENT CONNECTIONS TO THE RS-232 SERIAL PORT MUST BE IEC-60950 COMPLIANT. Nurse Call The nurse call feature on the Rad-8 Pulse Oximeter is based on the relay closing or opening depending on alarm, Low Signal IQ events or both. In addition the nurse call polarity can be inverted to accommodate various nurse call stations requirements. Refer to Section 4, Nurse Call and Polarity Menu, for details. WARNING: THE NURSE CALL FEATURE IS DISABLED WHEN THE AUDIBLE ALARMS ARE SILENCED WHILE THE NURSE CALL SETTING IS SET TO “ALARMS”.
7-4
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
7
NURSE CALL SPECIFICATIONS The nurse call features are accessible via the 1/4” round female connector on the rear panel of the instrument. Refer to the Section 2, Rad-8 Rear Panel, for details. The connector is item 1 on the panel. The connector can accommodate a mono or stereo type cable. The nurse call cable connections are described as follows: CABLE DESCRIPTION
NURSE CALL EVENT
Mono Cable
1
2
NO
1
Com
2
2 contacts normally opened (NO)
2 contacts normally closed (NC) Stereo Cable
1
2
3
NO
1
Com
2
NC
3
MENU SETTING Nurse Call Polarity Normal Nurse Call Polarity Inverse
1 and 2 contacts normally opened (NO)
Nurse Call
2 and 3 contacts normally closed (NC)
Polarity Normal
1 and 2 contacts normally closed (NC)
Nurse Call
2 and 3 contacts normally opened (NO)
Polarity Inverse
The nurse call relays have the following electrical specification per switch: PARAMETER
SPECIFICATION
MAX VOLTAGE
36 VDC or 24 VAC peak
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
7-5
sensors & patient cables
8
Introduction This section covers the use and cleaning of Masimo sensors and patient cables. Before use of any sensor, carefully read the sensor’s Directions for Use. Use only Masimo sensors and cables with the Rad-8 Pulse Oximeter. Other transducers, sensors and cables may affect Rad-8 performance. Tissue damage can be caused by incorrect application or use of a sensor, for example by wrapping the sensor too tightly. Inspect the sensor site as directed in the sensor Directions for Use to ensure skin integrity, correct positioning and adhesion of the sensor. CAUTIONS: ■ DO NOT USE DAMAGED SENSORS OR PATIENT CABLES. DO NOT USE A SENSOR OR PATIENT CABLE WITH EXPOSED OPTICAL OR ELECTRICAL COMPONENTS. ■ DO NOT IMMERSE THE SENSOR OR PATIENT CABLE IN WATER, SOLVENTS, OR CLEANING SOLUTIONS (THE SENSORS AND CONNECTORS ARE NOT WATERPROOF). ■ UNLESS OTHERWISE SPECIFIED, DO NOT STERILIZE SENSORS OR PATIENT CABLES BY IRRADIATION, STEAM, AUTOCLAVE OR ETHYLENE OXIDE. SEE THE CLEANING INSTRUCTIONS IN THE DIRECTIONS FOR USE FOR REUSABLE MASIMO SENSORS. ■ DO NOT ATTEMPT TO REPROCESS, RECONDITION OR RECYCLE ANY MASIMO SENSORS OR PATIENT CABLES AS THESE PROCESSES MAY DAMAGE THE ELECTRICAL COMPONENTS, POTENTIALLY LEADING TO PATIENT HARM. ■ ALL SENSORS AND CABLES ARE DESIGNED FOR USE WITH SPECIFIC MONITORS. VERIFY THE COMPATIBILITY OF THE MONITOR, CABLE AND SENSOR BEFORE USE, OTHERWISE PATIENT INJURY CAN RESULT. SELECTING A MASIMO SET SENSOR When selecting a sensor, consider the patient’s weight, the adequacy of perfusion, the available sensor sites, and the duration of monitoring. For more information refer to the following tables or contact your Sales Representative. Use only Masimo sensors and sensor cables. Select an appropriate sensor, apply it as directed, and observe all warnings and cautions presented in the Directions for Use (DFU) accompanying the sensor. Monitor, cables and sensors must be compatible to ensure optimal performance. Incompatible components effect operation or data recovery. High intensity extreme lights (such as pulsating strobe lights) directed on the Pulse Oximeter sensors, may not allow the sensor to obtain vital sign readings. High ambient light sources such as surgical lights (especially those with a xenon light source), bilirubin lamps, fluorescent lights, infrared heating lamps, and direct sunlight can interfere with the performance of the sensor. To prevent interference from ambient light, ensure that the sensor is properly applied, and cover the sensor site with opaque material, if required. Failure to take this precaution in high ambient light conditions may result in inaccurate measurements. SENSOR APPLICATION INSTRUCTIONS Unless indicated otherwise in the directions for use, reposition reusable sensors at least every 4 hours and for adhesive sensors inspect the site at least every 8 hours or sooner. If indicated by circulatory condition or skin integrity, reapply to a different monitoring site. Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
8-1
8
sensors & patient cables Masimo SpO2 Sensors Before use of any sensor or cable, carefully read the sensor or cable Directions for Use. Use only Masimo oximetry sensors and cables for SpO2 measurements. Other oxygen transducers or sensors may cause improper Rad-8 Pulse Oximeter performance. Tissue damage can be caused by incorrect application or use of a Masimo sensor, for example by wrapping the sensor too tightly. Inspect the sensor site as directed in the sensor Directions for Use to ensure skin integrity and correct positioning and adhesion of the sensor. CAUTIONS: ■ DO NOT USE DAMAGED SENSORS. DO NOT USE A SENSOR WITH EXPOSED OPTICAL OR ELECTRICAL COMPONENTS. DO NOT IMMERSE THE SENSOR IN WATER, SOLVENTS, OR CLEANING SOLUTIONS (THE SENSORS AND CONNECTORS ARE NOT WATERPROOF). DO NOT STERILIZE BY IRRADIATION, STEAM, OR ETHYLENE OXIDE. SEE THE CLEANING INSTRUCTIONS IN THE DIRECTIONS FOR USE FOR REUSABLE MASIMO SENSORS. ■ DO NOT USE DAMAGED PATIENT CABLES. DO NOT IMMERSE THE PATIENT CABLES IN WATER, SOLVENTS, OR CLEANING SOLUTIONS (THE PATIENT CABLE CONNECTORS ARE NOT WATERPROOF). DO NOT STERILIZE BY IRRADIATION, STEAM, OR ETHYLENE OXIDE. ■ ALL SENSORS AND CABLES ARE DESIGNED FOR USE WITH SPECIFIC MONITORS. VERIFY THE COMPATIBILITY OF THE MONITOR, CABLE AND SENSOR BEFORE USE, OTHERWISE PATIENT INJURY CAN RESULT. ■
DO NOT USE ADDITIONAL TAPE TO WRAP SENSOR.
RED DIRECT CONNECT SENSORS Masimo Red Direct sensors can be used with the Rad-8 to enable measurement of SpO2 and pulse rate only. Red Direct Connect sensors will only function with oximeter devices equipped with Masimo SET technology. Red Direct Connect sensors connect to the instrument directly. SENSOR DC-3 DC-12 DCP-3 DCP-12
8-2
Weight Range
Saturation Accuracy No Motion Motion
Pulse Rate Accuracy No Motion Motion
Low Perfusion Accuracy Saturation Pulse Rate
> 30 kg
± 2%
± 3%
± 3 bpm
± 5 bpm
± 2%
± 3 bpm
10 - 50 kg
± 2%
± 3%
± 3 bpm
± 5 bpm
± 2%
± 3 bpm
SENSOR
Weight Range
Red DCI-dc3
> 30 kg
Saturation Accuracy No Motion Motion ± 2% ± 3%
Pulse Rate Accuracy No Motion Motion ± 3 bpm ± 5 bpm
Low Perfusion Accuracy Saturation Pulse Rate ± 2% ± 3 bpm
Red DCI-dc12
> 30 kg
± 2%
± 3%
± 3 bpm
± 5 bpm
± 2%
± 3 bpm
Red DCIP-dc3
10 - 50 kg
± 2%
± 3%
± 3 bpm
± 5 bpm
± 2%
± 3 bpm
Red DCIP-dc12 10 - 50 kg
± 2%
± 3%
± 3 bpm
± 5 bpm
± 2%
± 3 bpm
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
8
sensors & patient cables
LNOP® REUSABLE SENSORS LNOP reusable sensors must be used in conjunction with Red PC cables. Weight Range
SENSOR LNOP DCI
Saturation Accuracy No Motion Motion ± 2% ± 3%
> 30 kg
LNOP DCIP 10 - 50 kg LNOP YI (Adults/Pediatrics) > 1 kg LNOP YI (Neonates) LNOP TC-I > 30 kg
± 2%
Pulse Rate Accuracy Low Perfusion Accuracy No Motion Motion Saturation Pulse Rate ± 3 bpm ± 5 bpm ± 2% ± 3 bpm
± 3%
± 3 bpm
± 5 bpm
± 2%
± 3 bpm
± 3%
± 3 bpm
± 5 bpm
N/A
N/A ± 3 bpm
± 2% ± 3% ± 3.5%
N/A
± 3 bpm
N/A
± 3.5%
LNOP DC-195
> 30 kg
± 2%
± 3%
± 3 bpm
± 5 bpm
± 2%
± 3 bpm
LNOP TF-I
> 30 kg
± 2%
N/A
± 3 bpm
N/A
± 2%
± 3 bpm
NOTE: The LNOP TF-I and TC-I sensors were not validated under motion conditions. TM
LNOPv ADHESIVE SENSORS LNOPv adhesive sensors must be used in conjunction with Red PC cables SENSOR LNOPv In
Weight Range 3 - 20 kg
Saturation Accuracy Pulse Rate Accuracy No Motion Motion No Motion Motion ± 2% ± 3% ± 3 bpm ± 5 bpm
Low Perfusion Accuracy Saturation Pulse Rate ± 2% ± 3 bpm
LNOPv Ne
< 3 kg
± 3%
± 3%
± 3 bpm
± 5 bpm
± 3%
± 3 bpm
LNOPv Ad
> 30 kg
± 2%
± 3%
± 3 bpm
± 5 bpm
± 2%
± 3 bpm
®
LNOP SPECIALTY SENSORS LNOP specialty sensors must be used in conjunction with Red PC cables SENSOR
Weight Range
Saturation Accuracy No Motion
Pulse Rate Accuracy
Low Perfusion Accuracy Motion No Motion Motion Saturation Pulse Rate
LNOP Newborn Infant 3 - 30 kg (thumb or great toe)
± 2%
± 3%
± 3 bpm
± 5 bpm
± 2%
± 3 bpm
10 - 30 kg
± 2%
± 3%
± 3 bpm
± 5 bpm
± 3%
± 3 bpm
< 3 kg
± 3%
± 3%
± 3 bpm
± 5 bpm
± 3%
± 3 bpm
> 30 kg
± 2%
± 3%
± 3 bpm
± 5 bpm
± 2%
± 3 bpm
N/A N/A
± 3 bpm ± 3 bpm
N/A N/A
± 3% ± 3%
± 3 bpm ± 3 bpm
N/A
± 3 bpm
N/A
± 3%
± 3 bpm
Infant (finger or toe) LNOP Newborn
Neonatal LNOP Trauma LNOP Blue
60 - 80% ± 4% 2.5 - 30 kg 70 - 100% ± 3.3% 80 -100% ± 3%
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
8-3
8
sensors & patient cables ®
LNCS REUSABLE SENSORS LNCS reusable sensors must be used in conjunction with Red LNC cables SENSOR
Weight Range
Saturation Accuracy No Motion Motion ± 2% ± 3%
Pulse Rate Accuracy No Motion Motion ± 3 bpm ± 5 bpm
Low Perfusion Accuracy Saturation Pulse Rate ± 2% ± 3 bpm
LNCS DCI
> 30 kg
LNCS DCIP
10 - 50 kg
± 2%
± 3%
± 3 bpm
± 5 bpm
± 2%
± 3 bpm
LNCS TC-I
> 30 kg
± 3.5%
N/A
± 3 bpm
N/A
± 3.5%
± 3 bpm
LNCS TF-I
> 30 kg
± 2%
N/A
± 3 bpm
N/A
± 2%
± 3 bpm
LNCS YI (Adult/Pediatric) LNCS YI (Neonates)
> 1 kg
± 3%
± 3 bpm
± 5 bpm
N/A
N/A
± 2% ± 3%
NOTE: The LNCS TF-I and TC-I sensors were not validated under motion conditions. ®
LNCS ADHESIVE SENSORS LNCS sensors must be used in conjunction with Red LNC cables SENSOR
Weight Range
LNCS Adtx > 30 kg LNCS Adtx-3 LNCS Pdtx 10 - 50 kg LNCS Pdtx-3 LNCS Inf-L LNCS Inf 3 - 20 kg LNCS Inf-3 LNCS Neo-L < 3 kg LNCS Neo > 40 kg LNCS Neo-3 LNCS NeoPt-L LNCS NeoPt-L < 1 kg LNCS NeoPt-3 LNCS NeoPt< 1 kg 500
Saturation Accuracy No Motion Motion
Pulse Rate Accuracy No Motion Motion
Low Perfusion Accuracy Saturation Pulse Rate
± 2%
± 3%
± 3 bpm
± 5 bpm
± 2%
± 3 bpm
± 2%
± 3%
± 3 bpm
± 5 bpm
± 2%
± 3 bpm
± 2%
± 3%
± 3 bpm
± 5 bpm
± 2%
± 3 bpm
± 3%
± 3%
± 3 bpm
± 5 bpm
± 3%
± 3 bpm
± 2%
± 3%
± 3 bpm
± 5 bpm
± 2%
± 3 bpm
± 3%
± 3%
± 3 bpm
± 5 bpm
± 3%
± 3 bpm
± 3%
± 3%
± 3 bpm
± 5 bpm
± 3%
± 3 bpm
M-LNCS™ DCI® & DCIP SENSORS SpO2 and pulse rate accuracy for the M-LNCS sensors is specified in the following table. These sensors must be used in conjunction with M-LNC™ cables. SENSOR Weight Range Saturation Accuracy, No Motion Saturation Accuracy, Motion Pulse Rate Accuracy, No Motion Pulse Rate Accuracy, Motion Low Perfusion Accuracy
8-4
Masimo SET Technology
Nellcor Technology
M-LNCS DCI
M-LNCS DCIP
M-LNCS DCI
M-LNCS DCIP
> 30 kg
10 - 50 kg
> 30 kg
10 - 50 kg
± 2%
± 2%
± 2%
± 2%
± 3%
± 3%
N/A
N/A
± 3 bpm
± 3 bpm
± 3 bpm
± 3 bpm
± 5 bpm
± 5 bpm
N/A
N/A
SpO2 ± 2%
SpO2 ± 2%
N/A
N/A
Pulse ± 3 bpm
Pulse ± 3 bpm
N/A
N/A
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
sensors & patient cables
8
SENSOR ACCURACY Refer to Section 7, Specifications for SpO2 and pulse rate accuracy, unless otherwise specified in the previous tables: Complete accuracy specifications are located in the sensor Directions For Use (DFU) and are specific for the type of Masimo sensor used. CLEANING AND REUSE OF MASIMO REUSABLE SENSORS AND CABLES Reusable sensors and patient cables can be cleaned per the following procedure: 1. 2. 3. 4. 5.
Remove the sensor from the patient. Disconnect the sensor from the patient cable. Disconnect the patient cable from the monitor. Wipe the entire sensor and/or patient cable clean with a 70% isopropyl alcohol pad. Allow to air dry thoroughly before returning it to operation.
CAUTION: CAREFULLY ROUTE PATIENT CABLES TO REDUCE THE POSSIBILITY OF PATIENT ENTANGLEMENT OR STRANGULATION. REATTACHMENT OF SINGLE USE ADHESIVE SENSORS Single use sensors may be reapplied to the same patient if the emitter and detector windows are clear and the adhesive still adheres to the skin. NOTE: If the sensor fails to track the pulse consistently, the sensors may be incorrectly positioned. Reposition the sensor or choose a different monitoring site. CAUTION: DO NOT ATTEMPT TO REPROCESS, RECONDITION OR RECYCLE ANY MASIMO SENSORS OR PATIENT CABLES AS THESE PROCESSES MAY DAMAGE THE ELECTRICAL COMPONENTS, POTENTIALLY LEADING TO PATIENT HARM. CAUTION: TO PREVENT DAMAGE, DO NOT SOAK OR IMMERSE THE SENSOR IN ANY LIQUID SOLUTION. DO NOT ATTEMPT TO STERILIZE BY IRRADIATION, STEAM, AUTOCLAVE OR ANY METHOD OTHER THAN ETHYLENE OXIDE AS INDICATED.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
8-5
service / maintenance
9
Introduction This chapter covers how to test the operation, properly clean and how to obtain service for the Rad-8 Pulse Oximeter. Under normal operation, no internal adjustment or recalibration is required. Safety tests and internal adjustments should be done by qualified personnel only. Safety checks should be performed at regular intervals or in accordance with local and governmental regulations. The Rad-8 Pulse Oximeter is a reusable instrument. The instrument is supplied and used non-sterile. WARNING: ELECTRICAL SHOCK AND FLAMMABILITY HAZARD - BEFORE CLEANING THE RAD-8, ALWAYS TURN IT OFF AND DISCONNECT THE POWER CORD FROM THE AC POWER SUPPLY. Cleaning The outer surface of the Rad-8 Pulse Oximeter can be cleaned with a soft cloth dampened with a mild detergent and warm water solution. Do not allow liquids to enter the interior of the instrument. The outer surface of the instrument can also be wiped down using the following solvents: Cidex Plus (3.4% Glutaraldehyde), 0.25% Ammonium Chloride, 10% Bleach, and 70% Isopropyl Alcohol. CAUTIONS: ■ DO NOT AUTOCLAVE, PRESSURE STERILIZE, OR GAS STERILIZE THE RAD-8. ■ DO NOT SOAK OR IMMERSE THE MONITOR IN ANY LIQUID. ■ USE THE CLEANING SOLUTION SPARINGLY. EXCESSIVE SOLUTION CAN FLOW INTO THE MONITOR AND CAUSE DAMAGE TO INTERNAL COMPONENTS. ■ DO NOT TOUCH, PRESS, OR RUB THE DISPLAY PANELS WITH ABRASIVE CLEANING COMPOUNDS, INSTRUMENTS, BRUSHES, ROUGH-SURFACE MATERIALS, OR BRING THEM INTO CONTACT WITH ANYTHING THAT COULD SCRATCH THE PANEL. ■ DO NOT USE PETROLEUM-BASED OR ACETONE SOLUTIONS, OR OTHER HARSH SOLVENTS, TO CLEAN THE OXIMETER. THESE SUBSTANCES AFFECT THE INSTRUMENT’S MATERIALS AND INSTRUMENT FAILURE CAN RESULT. Refer to Section 8, Cleaning and Reuse of Masimo Reusable Sensors and Cables, for cleaning instructions of the sensor.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
9-1
9
service / maintenance Battery Service WARNING: THE BATTERY SHOULD BE INSTALLED AND/ OR REMOVED FROM THE RAD-8 BY QUALIFIED PERSONNEL ONLY. Performance verification To test the performance of the Rad-8 after repairs or during routine maintenance, follow the procedure outlined in this section. If the Rad-8 fails any of the described tests, discontinue its use and correct the problem before returning the instrument back to the user. Before performing the following tests verify that the instrument is connected to AC power. Also disconnect any patient cables or probes or serial cables from the instrument. POWER-ON SELF-TEST: 1. Turn the monitor on by depressing the Power. For about 2 seconds all available LEDs are illuminated and a brief beep tone sounds. 2. The Rad-8 begins normal operation. KEY PRESS BUTTON TEST: 1. With the exception of the Power, press each button and verify that the instrument acknowledges each key-press with an audible beep tone or by indicating a change on the display. ALARM LIMIT TEST: 1. With the monitor turned on, depress the alarm limits button and enter the alarm menu. Change the High Saturation Alarm parameter to a value below the currently selected value, and accept the change. 2. Verify that the newly set parameter is shown on the Saturation Alarm Limit Display. 3. Return the High Saturation Alarm parameter to its original setting. 4.
5.
9-2
Repeat steps 1 to 3 for the following alarm parameters: ■
Low SpO2
■
Low and High pulse rate
Reset the alarm limits again to the original settings.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
service / maintenance
9
Performance verification continued LED BRIGHTNESS: 1. With the monitor turned on, press the Brightness Button once to enter the LED Brightness menu. The display will show the default setting Level 2. 2. Continue pressing the Brightness Button to scroll through the settings. 3. Press the Enter Button to accept the desired setting. Let the instrument time out for 10 seconds to exit to the home display screen. TESTING THE RAD-8 WITH MASIMO SET TESTER (OPTIONAL): 1. Turn the Rad-8 off and then on again. 2. Connect the Masimo SET Tester to the Pulse Oximeter Patient Cable Connector. 3. Verify that within 20 seconds all available pulse bars display. 4. Verify that the SpO2 measurement is between 79% and 84%. 5. Verify that the pulse rate measurement is between 55 bpm and 65 bpm. 6. Set the SpO2 low alarm limit to 90 (see Section 4, Setup Menu Level 1, Parameter/ Measurement Alarm Limits and Setup Menu Level 2, Alarm Volume). 7. Verify that an audible alarm activates, the SpO2 measurement and the SpO2 parameter label are flashing, and the Alarm Bell. 8. Press the Alarm Silence Button once and verify that the alarm is silenced and the Alarm Bell is flashing red. 9. Wait 120 seconds and verify that the alarm silence times out, the audible alarm is activated again and the Alarm Bell. 10. Press the up arrow button several times and verify that the loudness of the pulse beep tone increases. 11. Press the down arrow button and verify that the loudness of the pulse beep tone decreases until the pulse beep tone is turned off. 12. Reset the instrument to original settings and remove the tester to complete the procedure.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
9-3
9
service / maintenance Service and repair REPAIR POLICY Masimo or an authorized Service Department must perform warranty repair and service. Do not use malfunctioning equipment. Have the instrument repaired. WARNING: AN OPERATOR MAY ONLY PERFORM MAINTENANCE PROCEDURES SPECIFICALLY DESCRIBED IN THIS MANUAL. REFER SERVICING TO QUALIFIED SERVICE PERSONNEL TRAINED IN THE REPAIR OF THIS EQUIPMENT. Please clean contaminated and/or dirty equipment before returning, following the cleaning procedure described in Section 9, Cleaning. Make sure the equipment is fully dry before packing. To return the Rad-8 Pulse Oximeter for service, please follow the Return Procedure. RETURN PROCEDURE Please clean contaminated/dirty equipment before returning and make sure it is fully dry before packing the equipment. Call Masimo at 800-326-4890 and ask for Technical Support. Ask for an RMA number. Package the equipment securely – in the original shipping container if possible – and enclose or include the following information and items: ■ A letter describing in detail any difficulties experienced with the Rad-8. Please include the RMA number in the letter. ■ Warranty information – a copy of the invoice or other applicable documentation must be included. ■ Purchase order number to cover repair if the instrument is not under warranty, or for tracking purposes if it is. ■ Ship-to and bill-to information. ■ Person (name, telephone/Telex/fax number, and country) to contact for any questions about the repairs. ■ A certificate stating the Rad-8 has been decontaminated for bloodborne pathogens. Return the Rad-8 to the following shipping address:
9-4
For USA, Canada & Asia Pacific:
For Europe:
All other locations:
Masimo Corporation 40 Parker Irvine, California 92618 Tel: 949-297-7000 FAX: 949-297-7001
Masimo Europe Limited 304 RN6, Le Bois des Cotes 2 69760 Limonest France Tel: +33 (0) 472 17 93 70 FAX: +33 (0) 478 35 78 08
Contact your local Masimo Representative
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
service / maintenance
9
Sales & End-User License Agreement THIS DOCUMENT IS A LEGAL AGREEMENT BETWEEN YOU (“PURCHASER”) AND MASIMO CORPORATION (“MASIMO”) FOR THE PURCHASE OF THIS PRODUCT (“PRODUCT”) AND A LICENSE IN THE INCLUDED OR EMBEDDED SOFTWARE (“SOFTWARE”). EXCEPT AS OTHERWISE EXPRESSLY AGREED IN A SEPARATE CONTRACT FOR THE ACQUISITION OF THIS PRODUCT, THE FOLLOWING TERMS ARE THE ENTIRE AGREEMENT BETWEEN THE PARTIES REGARDING YOUR PURCHASE OF THIS PRODUCT. IF YOU DO NOT AGREE TO THE TERMS OF THIS AGREEMENT, PROMPTLY RETURN THE ENTIRE PRODUCT, INCLUDING ALL ACCESSORIES, IN THEIR ORIGINAL PACKAGES, WITH YOUR SALES RECEIPT TO MASIMO FOR A FULL REFUND. Warranty Masimo warrants to the initial Purchaser for a period of one (1) year from the date of purchase that: (i) each new Product and the Software media as delivered are free from defects in workmanship or materials, and (ii) the Product and Software will perform substantially as labeled in the directions for use. Masimo’s sole obligation under this warranty is to repair or replace any Product or Software that is covered under warranty. Batteries are warranted for six (6) months. To request a replacement under warranty, Purchaser must contact Masimo for a returned goods authorization. If Masimo determines that a Product must be replaced under warranty, it will be replaced and the cost of shipment covered. All other shipping costs shall be the responsibility of Purchaser. Exclusions The warranty does not extend to, and Masimo is not responsible for, repair, replacement, or maintenance needed because of: a) modification of the Product or Software without Masimo’s written authorization; b) supplies, devices or electrical work external to the Product or not manufactured by Masimo; c) disassembly or reassembly of the Product by anyone other than an authorized Masimo agent; d) use of the Product with sensors or other accessories other than those manufactured and distributed by Masimo; e) use of the Product and Software in ways or in environments for which they are not labeled; and f) neglect, misuse, improper operation, accident, fire, water, vandalism, weather, war, or any act of God. This warranty does not extend to any Product that has been reprocessed, reconditioned or recycled. This warranty also does not apply to any Products provided to Purchaser for testing or demonstration purposes, any temporary Products modules or any Products for which Seller does not otherwise receive a usage or purchase fee; all such Products are provided AS-IS without warranty.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
9-5
9
service / maintenance Exclusions continued THIS WARRANTY, TOGETHER WITH ANY OTHER EXPRESS WRITTEN WARRANTY THAT MAY BE ISSUED BY MASIMO IS THE SOLE AND EXCLUSIVE WARRANTY AS TO THE PRODUCT AND SOFTWARE. THIS WARRANTY IS EXPRESSLY IN LIEU OF ANY ORAL OR IMPLIED WARRANTIES, INCLUDING WITHOUT LIMITATION ANY IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. MASIMO SHALL NOT BE LIABLE FOR ANY INCIDENTAL, SPECIAL OR CONSEQUENTIAL LOSS, DAMAGE OR EXPENSE DIRECTLY OR INDIRECTLY ARISING FROM THE USE OR LOSS OF USE OF ANY PRODUCTS OR SOFTWARE. IN NO EVENT SHALL MASIMO’S LIABILITY ARISING FROM ANY PRODUCT AND SOFTWARE (UNDER CONTRACT, WARRANTY, TORT, STRICT LIABILITY OR OTHER CLAIM) EXCEED THE AMOUNT PAID BY PURCHASER FOR THE PRODUCTS GIVING RISE TO SUCH CLAIM. THE LIMITATIONS IN THIS SECTION SHALL NOT BE DEEMED TO PRECLUDE ANY LIABILITY THAT CANNOT LEGALLY BE DISCLAIMED BY CONTRACT. End-User License 1. Grant of License: In consideration of payment of the Software license fee, which is part of the price paid for the Product, Masimo grants to Purchaser a nonexclusive, nontransferable (except as set forth below) license (“License”), without right to sublicense, to use the copy of the Software in connection with Purchaser’s use of the Product for its labeled purpose as set forth in these directions for use. Masimo reserves all rights not expressly granted to Purchaser. 2. Ownership of Software: The Software is licensed not sold; all rights and interests in the Software and all copies thereof remain at all times vested in Masimo, and do not pass to Purchaser. Any references in this Agreement to the purchase or sale of the Software shall be deemed the purchase or sale of a Software License as set forth herein.
9-6
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
service / maintenance
9
Restrictions 1. Copyright Restrictions: The Software and the accompanying written materials are copyrighted. Unauthorized copying of the Software, including Software that has been modified, merged, or included with other software, or the written materials is expressly forbidden. Purchaser may be held legally responsible for any copyright infringement that is caused or incurred by Purchaser’s failure to abide by the terms of this Agreement. Nothing in this License provides any rights beyond those provided by 17 U.S.C. §117. 2. Use Restrictions: Purchaser may physically transfer the Product from one location to another provided that the Software is not copied. Purchaser may not electronically transfer the Software from the Product to any other device. Purchaser may not disclose, publish, translate, release, distribute copies of, modify, adapt, translate, reverse engineer, decompile, disassemble, or create derivative works based on the Software or the written materials. 3. Transfer Restrictions: In no event may Purchaser transfer, assign, rent, lease, sell, or otherwise dispose of the Product or the Software on a temporary basis. Purchaser shall not assign or transfer this License, in whole or in part, by operation of law or otherwise without Masimo's prior written consent; except that the Software and all of Purchaser’s rights hereunder shall transfer automatically to any party that legally acquires title to the Product with which this Software is included. Any attempt to assign any rights, duties or obligations arising hereunder other than as set forth in this paragraph shall be void. 4. U.S. Government Rights: If Purchaser is acquiring Software (including the related documentation) on behalf of any part of the United States Government, the following provisions apply: the Software and documentation are deemed to be “commercial software” and “commercial computer software documentation,” respectively pursuant to DFAR Section 227.7202 FAR 12.212, as applicable. Any use, modification, reproduction, release, performance, display or disclosure of the Software (including the related documentation) by the U.S. Government or any of its agencies shall be governed solely by the terms of this Agreement and shall be prohibited except to the extent expressly permitted by the terms of this Agreement.
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
9-7
10
Accessories Accessories PART NUMBER
DESCRIPTION
15111
Rad-8, Monitor Bag
33134
Rad-8 Operators Manual, French
33135
Rad-8 Operators Manual, German
33136
Rad-8 Operators Manual, Italian
33137
Rad-8 Operators Manual, Spanish
33140
Rad-8 Operators Manual, Swedish
33138
Rad-8 Operators Manual, Dutch
33139
Rad-8 Operators Manual, Danish
33141
Rad-8 Operators Manual, Portuguese
33142
Rad-8 Operators Manual, Chinese
33143
Rad-8 Operators Manual, Japanese
Rad-8 Signal Extraction Pulse Oximeter Operator’s Manual
10-1
Instruments and sensors containing Masimo SET technology are identified with the Masimo SET logo.
33116/5303C-0909
www.masimo.com
